Clinical and Experimental Medical Journal
Volume/Issue:
Volume 5: Issue 2-3
Outcome of subsequent IVF cycles after antibiotic therapy following previously failed IVF cycles. Study II
Authors: Attila Toth 1 , 2 , 3 and Addison B. Toth
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  • 1 MacLeod Laboratory, New York Presbyterian Medical Center, New York, USA
  • 2 New York Presbyterian Medical Center, New York, USA
  • 3 MacLeod Laboratory, New York Presbyterian Medical Center, 65 East 79th Street, New York, NY, 10075, USA
DOI:
https://doi.org/10.1556/CEMED.5.2011.2.9
Page Count:
143–153
Publication Date:
01 Jun 2011
Online Publication Date:
01 Jun 2011
Article Category:
Research Article
Restricted access

Abstract

Objective: To determine whether broad-spectrum antibiotic therapy administered after a failed in vitro fertilization (IVF) cycle will improve the chance of achieving a successful pregnancy in the subsequent IVF cycle and to determine whether further antibiotic therapy administered immediately after conception, during the course of pregnancy, and at the time of delivery will reduce the incidence of maternal and fetal complications. Design: A retrospective analysis was performed on the clinical data of 63 couples who had previously failed one or more IVF cycles and were subsequently treated with broad-spectrum antibiotics. All women were treated with intravenous Clindamycin and daily intrauterine lavages using a broad-spectrum antibiotic combination. All men received intravenous Clindamycin and simultaneously underwent five direct transrectal injections of an antibiotic cocktail into the prostate gland if clinical or sonographic evidence of chronic prostatitis was documented. For both men and women, these regimens were followed by a month-long oral course of Zithromax and Macrobid. Following either a spontaneous pregnancy or a repeat IVF conception, a 10-day antibiotic course was administered in the form of oral Cleocine or intravenous Clindamycin. Some women received intermittent oral antibiotic courses throughout the pregnancy and prophylactic antibiotics during delivery. Results: When compared with our previous study (Study I, [24]), the number of spontaneous pregnancies was significantly higher and the total number of births was also significantly higher. Following the antibiotic therapy, there was a significantly improved chance for the couples to achieve a successful IVF pregnancy when compared to historical controls in conventional repeat IVF cycles. For singleton pregnancies, there were no perinatal maternal or fetal complications. Conclusion: These results support our previous findings, showing that antibiotic therapy can reduce IVF failures in subsequent cycles. The reduced number of maternal and fetal complications after antibiotic therapy in this retrospective study is impressive and warrants a prospective, randomized trial for confirmation.

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Cover Clinical and Experimental Medical Journal
Clinical and Experimental Medical Journal
Print ISSN:
2060-6249
Online ISSN:
2060-968X
Keywords:
cumulative pregnancies; IVF; antibiotics and IVF; perinatal complications and antibiotics; IVF failure and infections; A7 Differential agar, a solid medium used for detection and identification of ureaplasma urealyticum and mycoplasma; API system, (active pharmaceutical ingredient), a multitube micro method for identification of bacteria and yeast; BD test, Breslow-Day test, test of homogeneous association; CI, confidence interval; GA, gestational age; IVF, in vitro fertilization; IUGR, intrauterine growth restriction; MH test, Mantel-Haenszel statistical test. The purpose of the MH is to estimate the average conditional association between the explanatory and the response variable; NICU, newborn intensive care unit; P-value, probability; PCR, polymerase chain reaction; Rapid-NH, specialized media for gonorrhea and hemophilus identification; PROM, premature rupture of membranes; RCRC Institutional Review Board, Reviews the merit of a scientific work before submission for publication; SD, standard deviation; TV pouch, liquid medium for Trichomonas vaginalis culture

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