**1. Introduction**

There were approximately 37 million people living with human immunodeficiency virus (PLWHIV) globally at the end of 2014.[1] The course of HIV infection has changed from a deadly disease to a chronic and manageable disease since the introduction of combination antiretroviral therapy (cART) in the 1990s. The estimated life expectancy of a 20-year-old PLWHIV has increased from 30 years during 1996–1999 to 46 years during 2006–2008 accord‐ ing to the UK Collaborative HIV Cohort Study.[2] The increased life expectancy along with improved quality of life has led to increase in reproductive desire among this population.[3] Fertility of PLWHIV can be affected by HIV infection and associated infections. Infections can physically impact the anatomical structure and biological function of the reproductive system, whereas stress and psychiatric disorders related to HIV infection may lessen sexual drive and frequency of sexual intercourse. In addition, socioeconomic factors including limited financial means, difficulty accessing HIV care, and stigmatization can contribute to social withdrawal and reduced reproductive potential among PLWHIV. Management of reproductive health along with cART has become a necessary component of comprehensive HIV care in the post– cART era. The etiologies and epidemiology of HIV-related infertility, factors that may impact fertility, and management options and considerations for infertility among HIV-infected individuals are reviewed in this chapter.
