1. ESHRE 26th Annual Meeting,Rome. Wednesday 30 June 2010 ESHRE Members’ information session New task force - Fertility and viral disease Enrico Semprini (Italy)

2. New: Task Force – Fertility and Viral Diseases • Coordinator: Augusto E. Semprini • Aim:This Task Force aims to offer a platform of collaboration between ESHRE and the "Centres for Reproductive Assistance Techniques in HIV in Europe" (CREATHE), which is a non-profit association committed to improving the quality and availability of safer conception options to couples who are affected by HIV and/or other transmissible infections and who wish to become parents. • These couples are nowadays subject to discrimination regarding their basic rights for parenthood and for having a family, due to the fear of transmitting the infection to the healthy partner while attempting at conception. • CREAThE O.N.L.U.S. is an NGO registered under Italian law .(www.creathe.org) • CREAThE is an open network welcoming the inclusion of all figures involved in the field of reproductive care to couples with HIV. To

3. Task Force – Fertility and Viral Diseases The key objectives of CREATHE are: To promote the availability of services of assisted reproduction to couples affected by HIV or by other sexually transmitted infections. To promote the offer of services of specific sperm washing to clinical centres unequipped in carrying out this method who intend to offer reproductive assistance to couples affected by HIV or by other sexually transmitted infections. To spread knowledge and experience regarding the method of sperm washing and regarding reproductive assistance to couples affected by HIV or by other sexually transmitted infections, to physicians and biologists who intend applying this method.

4. Reproductive Centres ITALYStudio Semprini, MilanoCentro di medicina preventiva, Verona NETHERLANDSAcademisch Medisch Centrum, Amsterdam SPAINHospital Galdakao-UsansoloHU Virgen de las Nieves, Granada SOUTH AFRICAUniversity hospital, Pretoria SWITZERLANDKantonsspital St. Gallen, St. GallenClinique La Source, Lausanne U.K.Chelsea&Westminster hospital, London BELGIUMSaint-Pierre hospital, BruxellesErasme hospital, Bruxelles DENMARKRigshospitale, CopenhagenFRANCEHospital Paule de Viguier, ToulouseCMCO-SIHCUS, SchiltigheimCHU de LyonHòpital Cochin, ParisHòpitalPitié-Salpètrière, ParisCHU de Rennes GERMANYFertility Center, Berlin ISRAELRambam hospital, Haifa

5. Where do we come from? • Insemination of HIV-negative women with processed semen of HIV-positive partners. (AE Semprini -Lancet. 1992) • NATURAL CONCEPTION IN HIV-NEGATIVE WOMEN WITH HIV-INFECTED PARTNERS (L Mandelbrot Lancet 1997) • QUANTIFICATION OF HIV IN SEMEN: CORRELATION WITH ANTIVIRAL TREATMENT AND IMMUNE STATUS (PL Vernazza- AIDS 1997) • REPRODUCTIVE COUNSELLING FOR HIV-DISCORDANT COUPLES(AE Semprini- Lancet 1997)

6. Percoll Gradient HIV Infection 45% NSCs yes 90% No Motil spermatozoa HIV in semen: sperm washing

7. Gradient „swim-up“ 45% Insem. 90% Semen preparation: sperm washing

8. Publications • Safety and efficacy of sperm washing in HIV-1-serodiscordant couples where the male is infected:results from the European CREAThE network. Bujan L, Hollander L et al. for the CREAThE network. AIDS 21:1909–1914, 2007Establishing the safety profile of sperm washing followed by ART for the treatment of HIV discordant couples wishing to conceive. A E Semprini , L Bujan et al. Hum Reprod. 2007 Jul 3HIV-discordant couples and parenthood: how are we dealing with the risk of transmission?Vernazza PL; Hollander L et al. AIDS 20(4): 635, 2006Multicenter Quality Control of the Detection of HIV-1 Genome in Semen Before  Medically Assisted Procreation. Pasquier C, Anderson D et al. and The CREAThE Network. J Med Virol 78: 877-882, 2006

9. Projects • Retrsospective evaluation of the safety and efficacy of semen washing in HIV discordant couples • Retropsective evaluation of the outcome of infertility treatment in HIV positive women • SHARE – Studying HIV And Reproduction in Europe – European registry of reproductive assistance to couples with HIV • Multicenter Quality Control of the Detection of HIV-1 Genome in Semen Before Medically Assisted Procreation

10. Previous Collaboration with CDC • CONRAD's Mission • CONRAD's overall goal is to improve reproductive health, especially in developing countries.  Our main objective is to help develop safe, acceptable, affordable products and methods that provide contraception and/or prevent the sexual transmission of HIV/AIDS and other infections • Manuscript submitted for publication

11. Task Force – Fertility and Viral Diseases ESHRE- CREAThE Ongoing projects • Web survey on the “Management of HIV-patients requesting reproductive assistance” • SHARE protocol and database • Pre Congress Course in Stockolm 2011 “Assisted Reproduction in couple with HIV” • Campus for healthcare professionals “ Viral Infections in Reproductive medicine “ Berlin 2012 • Position Papers