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Round-table multidisciplinary counselling of couples with HIV prior to assisted reproduction
Journal
Reproductive biomedicine online
Volume
17
Number
2
Pages / Article-Number
167-74
Keywords
assisted reproduction, HIV discordance, infertility counselling, multidisciplinary approach, sperm preparation
Abstract
Assisted reproduction is used to support couples with human immunodeficiency virus (HIV) in achieving pregnancy without compromising the health of the partner or the offspring. This complex situation requires a joint effort by experts from different medical fields over prolonged periods. In order to fulfil all requirements, a comprehensive multidisciplinary counselling approach was initiated through round-table conventions of experts together with individual couples. The aim of this novel approach was an informed sharing of responsibility in the decision-making process, and also to ensure the adherence of the couples. The experts' and the couples' experience of the multidisciplinary meetings was evaluated using structured questionnaires. A total of 34 couples were referred, 15 with the male partner HIV infected, 15 with the female partner infected, four with both partners infected. Twenty-two couples participated in the multidisciplinary counselling. Three couples withdrew after counselling. Fourteen pregnancies were achieved leading to the birth of eight children. The experts viewed the panel's composition and the decision-making process as valuable, necessary and beneficial to the couples. The responding couples considered the meetings to be clarifying and helpful and they felt respected. It is concluded that the round-table multidisciplinary meeting approach is a feasible option for HIV-affected couples with infertility.
