Erfolgreiche assistierte Reproduktion bei einer HIV-infizierten Patientin - ethische und medizinische Aspekte

Abstract

The development of highly effective treatment regimens for patients with HIV infection over the last decades has led to prolonged survival times and an improvement of quality of life. Furthermore, the current management of the treatment of pregnant HIV-infected women with an elective Cesarean section, a highly active antiretroviral therapy of mother and child and the renunciation of breast-feeding has resulted in a reduction of the risk of perinatal transmission to < 2 %. Therefore, more and more women with HIV infection wish to become pregnant. There is a strong ethical debate about the management of fertility problems and the use of assisted reproductive medicine in these women. In this case report we describe the treatment of sterility of a HIV discordant couple with HIV infection of the woman and male infertility because of an oligo-astheno-terato-zoospermia. Treatment of infertility was carried out at the Fertility Center Berlin at the hospital DRK Klinikum Westend by in vitro fertilisation. Beforehand, we consulted with the responsible ethics committee. Ethical, moral, psychosocial and legal aspects were discussed at length. The care of the couple occurred in cooperation with experts in the field of HIV infection. It included treatment of mother and child according to the general clinical standards. In February 2005 a healthy child without HIV infection was born.