英国HIV感染和生育保健的需求与供给

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Objective: To collect data on the demand and provision of fertility care in HIV- infected couples in the United Kingdom and data on the etiology of subfertility in this population.Design: A postal questionnaire survey and audit of causes of infertility in HIV- infected women.Setting: Seventy- four Human Embryology and Fertilisation Authority- registered assisted conception units (ACUs) and 294 genitourinary medicine (GUM) clinics in the United Kingdom were sent questionnaires.Patient(s): Sixty- five HIV- infected women attending the Research Clinic at the Chelsea and Westminster ACU. Intervention(s): None. Main Outcome Measure(s): Number of ACUs treating HIV- infected patients and number of GUM clinics receiving requests for referral, as well as the etiology of subfertility in HIV infected women attending our clinic.Re-sult(s): Response rates from ACUs and GUM clinics were 93% and 63% , respectively.Fourteen ACUs (20% ) were treating HIV- infected men; of these, seven (10% ) performed sperm washing, but only two (3% ) tested sperm for HIV after processing, before use.Nine units (13% ) treated HIV- infected women, but only three ACUs (4% ) had separate laboratories for handling potentially infected gametes or embryos.Of the 15, 211 patients registered in 81 GUM clinics, 4% of the men and 16% of the women had requested advice on conceiving.An audit of the Chelsea and Westminster HIV fertility clinic demonstrated a 40% prevalence of tubal factor infertility in HIV- infected women.Conclusion(s): Demand is high, and set to increase, but current suboptimal practice in some centers is placing unaffected partners and the unborn child at risk of seroconversion. Objective: To collect data on the demand and provision of fertility care in HIV-infected couples in the United Kingdom and data on the etiology of subfertility in this population.Design: A postal questionnaire survey and audit of causes of infertility in HIV-infused women .Setting: Seventy-four Human Embryology and Fertilisation Authority- registered assisted conception units (ACUs) and 294 genitourinary medicine (GUM) clinics in the United Kingdom sent questionnaires.Patient(s): Sixty- five HIV-virus women attending the Research Clinic at the Chelsea and Westminster ACU. Intervention(s): None. Main Outcome Measure(s): Number of ACUs treating HIV-infected patients and number of GUM clinics receiving requests for referral, as well as the etiology of subfertility in HIV infected Women attending our clinic.Re-sult(s): Response rates from ACUs and GUM clinics were were 93% and 63%, respectively.Fourteen ACUs (20%) were treated HIV- infected men; of these, seven (10% ) performed Sperm washing, but only two (3% ) tested sperm for HIV after processing, before use.Nine units (13% ) treated HIV- infected women, but only three ACUs (4% ) had separate laboratories for handling potentially infected gametes or embryos .Of the 15, 211 patients registered in 81 GUM clinics, 4% of the men and 16% of the women had requested advice on conceiving.An audit of the Chelsea and Westminster HIV fertility clinic showed a 40% prevalence of tubal factor infertility in HIV-infected women.Conclusion(s): Demand is high, and set to increase, but current suboptimal practice in some centers is placing unaffected partners and the unborn child at risk of seroconversion.
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