TY - JOUR T1 - P17.30 A feasibility study assessing fertility in hiv-serodiscordant couples attempting pregnancy in kisumu, kenya JF - Sexually Transmitted Infections JO - Sex Transm Infect SP - A234 LP - A234 DO - 10.1136/sextrans-2015-052270.608 VL - 91 IS - Suppl 2 AU - O Mmeje AU - A Murage AU - B Njoroge AU - S van der Poel AU - CR Cohen Y1 - 2015/09/01 UR - http://sti.bmj.com/content/91/Suppl_2/A234.2.abstract N2 - Background HIV-serodiscordant couples desiring children face the difficult choice between risking transmission through condomless intercourse to become pregnant and the social stigmatisation of being childless. In sub-Saharan Africa, 14.3 million women are HIV-infected and many exercise their reproductive right to achieve pregnancy; however, though often overlooked, fertility problems due to tubal damage, menstrual cycle irregularities, and diminished ovarian reserve may affect these women.Methods A study of female positive/male negative (♀+/♂-) HIV-serodiscordant couples using timed vaginal insemination (TVI) as a safer method of conception was conducted in Kenya. A fertility evaluation was offered to couples unable to achieve pregnancy after six cycles of TVI. Men completed a semen analysis and women a hystero-salpingo-contrast-sonography (HyCoSy) to investigate the uterus, ovaries, and fallopian tubes.Results Fifteen of 23 ♀+/♂- HIV-serodiscordant couples were eligible for fertility evaluations; 14 consented; and seven completed male and female fertility assessments. The mean age of the men and women who completed fertility evaluations was 33.7 (std. dev. = 4.58), and 30 (std. dev. = 5.41) years, respectively. Fertility evaluations determined that three women had bilateral fallopian tube occlusion with one male partner having decreased sperm motility; and four women had unilateral/bilateral fallopian tube patency. Seven couples declined or were unable to complete a full couple evaluation. Of the 14 women evaluated, six (46%) had an HIV RNA viral load (≥400 copies/mL); six (46%) had an undetectable HIV RNA viral load; and two declined serum assessment.Conclusion Amongst HIV-serodiscordant couples attempting to achieve pregnancy, underlying male and/or female factor infertility and inadequate viral suppression may be present. As safer conception interventions are integrated into HIV care programs, a fertility evaluation should be offered, if feasible and available, to HIV-affected individuals/couples planning a pregnancy, to optimise their conception efforts, decrease HIV transmission, and assess their potential to conceive without assistance.Disclosure of interest statement This research was supported in part by a grant from the National Institutes of Health (NIH), University of California San Francisco-Gladstone Institute of Virology and Immunology Centre for AIDS Research (P30 AI027763) and the United Nations jointly sponsored HRP Special Research Programme. O. Mmeje was partly supported by NIH/T32–5T32AI065388–03. ER -