For HIV -1-infected men and women the introduction of highly active antiretroviral therapy (HART) in 1996 led to a spectacular increase in life expectancy and quality of life. In Western society where HART is readily available, HIV -1 is now considered to be a chronic disease and as a consequence quality of life is an important aspect for men and women with HIV-1. Many of them express the desire to father or mother a child. Assisted reproductive technologies, including intrauterine insemination (IUI), in vitro fertilisation (IVF) and intracytoplasmatic sperm injection (ICSI) in combination with semen washing have been used to decrease the risk of HIV -1 transmission in HIV-1-infected discordant couples with an HIV-1-infected man. This article aims to summarise the current state of the art of assisted reproductive technologies for couples with an HIV -1-infected man and to discuss current trends and dilemmas in the treatment of these couples.