RESUMO
This report documents the case of a 36-year-old female diagnosed with stage I invasive ductal carcinoma of the left breast who, alongside her 39-year-old husband, sought fertility assistance at our center due to primary infertility. Having survived cancer twice in the span of their seven-year marriage, the couple faced the challenge of overcoming both the repercussions of cancer treatment and difficulties in conceiving. Initial attempts through three intrauterine insemination (IUI) cycles proved unsuccessful, leading the couple to opt for in vitro fertilization (IVF). The fertility assessment of the husband revealed the presence of several pus cells and a high sperm DNA fragmentation index (DFI). To address this, a medication regimen was administered to improve sperm quality. Concurrently, the female underwent controlled ovarian stimulation (COS) with the anti-estrogen agent letrozole to mitigate the risk of estrogen surges that could compromise her health. Subsequently, oocytes were retrieved from the female, and intracytoplasmic sperm injection (ICSI) was used to facilitate fertilization with her husband's sperm. Following successful embryo development, the patient underwent embryo transfer (ET), resulting in a positive beta-human chorionic gonadotropin (beta-hCG) result, signifying a successful conception. This case report highlights the intricate challenges faced by individuals with a history of breast cancer, emphasizing the delicate balance required in managing infertility in such circumstances. The described approach, involving personalized treatments and meticulous care, underscores the possibility of achieving successful conception for females struggling with fertility issues post-cancer survival. The documented journey serves as a testament to the resilience of individuals facing the dual challenges of cancer survival and infertility, offering insights into the complexities of their reproductive healthcare.
RESUMO
Human immunodeficiency virus (HIV) is a virus that affects the immune system and attacks immune cells called CD4 while also raising the risk and severity of other infections and diseases. Despite the fact that HIV can infect persons of any age, the majority of infected people are those of reproductive age between 15 and 44 years. Many women and men with HIV desire children. Plenty of HIV-positive adults worldwide wish to have a child. As a result, reproductive desires have emerged as clinically significant in patients with HIV/acquired immunodeficiency syndrome (AIDS). We present a case of a 35-year-old male who is HIV-1 seropositive and his 32-year-old healthy wife who is seronegative who visited an in vitro fertilization (IVF) clinic. The couple was married for four years, facing primary infertility, and had a history of failure of three successive intrauterine insemination (IUI) cycles. The couple abstained from physical contact when the husband was discovered HIV positive. The couple wanted to have their own biological, completely healthy child. The male was undertaking highly active antiretroviral therapy (HAART). On the performance of the semen analysis test, the male was discovered to have oligospermia. The blood test of the female revealed that her anti-Mullerian hormone (AMH) level was raised, and ultrasound indicated polycystic ovarian syndrome (PCOS). The couple was suggested IVF/intracytoplasmic sperm injection (ICSI) treatment due to failure of IUI cycles in the past. Medications were given to the wife for her PCOS. Self-oocytes were retrieved from the wife, and the husband's semen sample was washed with the semen washing method (density gradient (DG) and swim up). By confirming in the sample that HIV is not present, ICSI was done. Three blastocyst stage embryos were transferred on day 6 of progesterone. After 14 days, the test report of the ß-human chorionic gonadotropin (hCG) hormone came positive. Around 39 weeks later, she successfully delivered a baby boy who was later tested for HIV, and the report was negative.
