Human immunodeficiency virus (HIV) and infertility treatment: a committee opinion
Ethics Committee of American Society for Reproductive Medicine
Committee members:Judith Daar, Paula Amato, Jean Benward, Lee Rubin Collins, Joseph Davis, Senait Fisseha, Leslie Francis, Elena Gates, Sigal Klipstein, Barbara Koenig, Laurence McCullough, Robert Rebar, Richard Reindollar, Mark Sauer, Rebecca Sokol, Monique Spillman, Andrea Stein, Sean Tipton, Bruce Wilder, Laurie Zoloth, …
Ethics Committee of American Society for Reproductive Medicine (2015). Human immunodeficiency virus (HIV) and infertility treatment: a committee opinion. Fertility and sterility. https://doi.org/10.1016/j.fertnstert.2015.04.004
Ethics Committee of American Society for Reproductive Medicine. Human immunodeficiency virus (HIV) and infertility treatment: a committee opinion. Fertility and sterility. 2015. doi:10.1016/j.fertnstert.2015.04.004
Ethics Committee of American Society for Reproductive Medicine. "Human immunodeficiency virus (HIV) and infertility treatment: a committee opinion." Fertility and sterility, 2015.
For EndNote, Zotero or Mendeley:
Open access
Free to read
No reuse license
Free to read at the publisher (reported by Unpaywall and OpenAlex, not verified by RRM Academy)
RRM Academy Synopsis
ASRM finds no ethical bar to HIV fertility care at equipped clinics
The ASRM Ethics Committee holds in a 2015 opinion that well-equipped clinics have no ethical reason to withhold fertility services from people with HIV. The position applies to people who accept therapies that lower transmission risk.
Key Findings
At clinics with the needed resources, the committee finds "no ethical reason to withhold fertility services" from HIV-infected people and couples who accept recommended risk-reducing therapies.
A clinic lacking those resources "should assist in referral." The committee says going ahead without the clinical and laboratory means to care for these couples would not be "ethically acceptable."
For couples in which the man has HIV, the committee does not recommend timed unprotected intercourse, though some couples have conceived this way without infection.
The committee calls it "ethically appropriate" to encourage HIV testing for all couples planning a child. It says one can argue that mandating tests only for infertility patients would unreasonably infringe liberty.
The committee holds that donors and carriers should learn an intended parent's HIV status through informed consent. A carrier must get full disclosure when the intended father's sperm is used, it says.
Interpretation
The ASRM Ethics Committee built this opinion on argument and earlier reports. One report followed 181 couples for 10 years. None of the women caught HIV from their partners in that time. The committee calls those numbers "reassuring" and says "more data are needed." The opinion updates ASRM's 2010 statement on the same question. Larger studies would sharpen this picture further.
RRM Context
The opinion says couples with HIV may have normal or impaired fertility, as any couple presenting for evaluation might. Sperm preparation with IUI or IVF with ICSI, the routes it describes, limits transmission risk. Those routes bypass the question of why conception has not happened. Restorative reproductive medicine evaluates both partners for that cause before treatment.
Our editorial summary of this paper, not the article's abstract.
Abstract
Human immunodeficiency virus (HIV) is a serious but manageable chronic disease that affects persons of reproductive age, many of whom express a desire for biologic parenthood. This document is a revision of the original document of the same name, last published in 2010 (Fertil Steril 2010;94:11-5).
Clinical Guidelines and Standards › Guidelines by Clinical Area › Fertility and Infertility Guidelines · Assisted Reproduction › Safety and Risks › Procedural Safety · Ethics and Policy › Reproductive Ethics › Access to Treatment
Judith Daar, Paula Amato, Jean Benward, Lee Rubin Collins, Joseph Davis, Senait Fisseha, Leslie Francis, Elena Gates, Sigal Klipstein, Barbara Koenig, Laurence McCullough, Robert Rebar, Richard Reindollar, Mark Sauer, Rebecca Sokol, Monique Spillman, Andrea Stein, Sean Tipton, Bruce Wilder, Laurie Zoloth, 0000-0003-0284-2845
J Daar, P Amato, J Benward, L Collins, Joe Davis, Joey Davis, J Davis, S Fisseha, L Francis, E Gates, S Klipstein, Barb Koenig, B Koenig, Larry McCullough, L McCullough, Bob Rebar, Rob Rebar, Bobby Rebar, R Rebar, Rick Reindollar, Dick Reindollar, Rich Reindollar, R Reindollar, M Sauer, Becky Sokol, R Sokol, M Spillman, A Stein, S Tipton, B Wilder, L Zoloth
PMID 25956374 25956374 DOI 10.1016/j.fertnstert.2015.04.004 10.1016/j.fertnstert.2015.04.004 Ethics Committee of American Society for Reproductive Medicine et al. 2015, Ethics Committee of American Society for Reproductive Medicine 2015
Breaking Up with IVF Free for membersMidwife and former front-line IVF clinician Dr. Jennifer Mercier joins Dr. Naomi Whittaker for a candid Save the Uterus Club conversation. 
Masterclass in Endometriosis & Surgery 9 sectionsComprehensive guide for patients preparing for endometriosis surgery. 
Hormones Through the Lifespan Free for membersA comprehensive overview of hormonal health across a woman's life, menstrual cycles, common conditions, and the transition to menopause, presented by Dr. Ana Garcia, OB/GYN. 
