Abstract
Objective To present the first reported case of synchronous sperm retrieval followed by sperm washing before an intracytoplasmic sperm injection (ICSI) cycle in an HIV-positive azoospermic man. Design Case report. Setting Assisted reproduction center. Patient(s) A 40-year-old HIV-positive man with obstructive azoospermia due to vasal aplasia. Intervention(s) Synchronous sperm retrieval, sperm washing, nucleic acid–based sequence amplification testing, and intracytoplasmic sperm injection. Main outcome measure(s) Successful sperm retrieval sufficient for sperm washing and fertilization. Result(s) Sufficient quantity of spermatozoa for washing was obtained at epididymal aspiration. After the wash, HIV ribonucleic acid (RNA) was undetectable with nucleic acid–based sequence amplification testing, enabling injection of oocytes collected after routine gonadotropin superovulation. Of seven oocytes collected from the 39-year-old woman partner, six were injected and five fertilized (83%). Three embryos were transferred on day 2. The pregnancy test was negative on this occasion. Conclusion(s) This case demonstrates that sperm washing can be applied in cases of sperm retrieval where sperm volume and density is low, allowing the treatment of azoospermic HIV-positive men.
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