Antibiotic treatment based on seminal cultures from asymptomatic male partners in in-vitro fertilization is unnecessary and may be detrimental

N. H. Liversedge, J. M. Jenkins, S. D. Keay, E. A. McLaughlin, H. Al-Sufyan, L. A. Maile, L. A. Joels, M. G.R. Hull

Research output: Contribution to journalArticle

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Abstract

We questioned the policy of routine microbiological culture of semen prior to in-vitro fertilization (IVF) with a view to prescribing antibiotics to reduce the risk of introducing seminal infection into the embryo culture system. An initial retrospective study examined semen microbiology reports of 449 couples undergoing IVF or gamete intra-Fallopian transfer (GIFT). In semen samples taking ≤ 1 days to reach the microbiology laboratory compared with same-day delivery there was increased frequency of significant culture of enterococci (27 versus 15%, P < 0.01). In samples taking ≤ 2 days there was increased frequency of significant culture of Gram-negative bacilli (31 versus 12%, P < 0.01) and of overall culture of other potentially pathogenic organisms (26 versus 14%, P < 0.01). We questioned diagnostic accuracy and relevance. Therefore, in a prospective study, semen and high vaginal swabs obtained on the day of oocyte collection were cultured from 100 couples having IVF or GIFT, of whom 52 male partners had been treated with antibiotics following positive pre-IVF semen culture. The presence of bacteria in semen samples used only for IVF (n = 90) did not reduce fertilization rates nor lead to infection of the embryo culture system. However, there was an increased incidence of significant culture of vaginal Gram-negative bacilli in patients with treated partners compared with untreated partners [15/52 (29%) versus 5/48 (10%), P < 0.05]. Thus antibiotic therapy in the male partner may increase the likelihood of inoculation of antibiotic-resistant pathogenic bacteria from the vagina into the embryo culture system during vaginal oocyte collection. In asymptomatic patients, microbiological screening of semen samples prior to IVF treatment and subsequent treatment with antibiotic therapy in those with positive cultures appears to be unnecessary and may be detrimental to IVF outcome.

Original languageEnglish
Pages (from-to)1227-1231
Number of pages5
JournalHuman Reproduction
Volume11
Issue number6
DOIs
Publication statusPublished - 1 Jun 1996
Externally publishedYes

Fingerprint

Fertilization in Vitro
Semen
Anti-Bacterial Agents
Oocyte Retrieval
Embryonic Structures
Microbiology
Germ Cells
Bacillus
Therapeutics
Bacteria
Enterococcus
Vagina
Infection
Fertilization
Retrospective Studies
Prospective Studies
Incidence

Cite this

Liversedge, N. H. ; Jenkins, J. M. ; Keay, S. D. ; McLaughlin, E. A. ; Al-Sufyan, H. ; Maile, L. A. ; Joels, L. A. ; Hull, M. G.R. / Antibiotic treatment based on seminal cultures from asymptomatic male partners in in-vitro fertilization is unnecessary and may be detrimental. In: Human Reproduction. 1996 ; Vol. 11, No. 6. pp. 1227-1231.
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abstract = "We questioned the policy of routine microbiological culture of semen prior to in-vitro fertilization (IVF) with a view to prescribing antibiotics to reduce the risk of introducing seminal infection into the embryo culture system. An initial retrospective study examined semen microbiology reports of 449 couples undergoing IVF or gamete intra-Fallopian transfer (GIFT). In semen samples taking ≤ 1 days to reach the microbiology laboratory compared with same-day delivery there was increased frequency of significant culture of enterococci (27 versus 15{\%}, P < 0.01). In samples taking ≤ 2 days there was increased frequency of significant culture of Gram-negative bacilli (31 versus 12{\%}, P < 0.01) and of overall culture of other potentially pathogenic organisms (26 versus 14{\%}, P < 0.01). We questioned diagnostic accuracy and relevance. Therefore, in a prospective study, semen and high vaginal swabs obtained on the day of oocyte collection were cultured from 100 couples having IVF or GIFT, of whom 52 male partners had been treated with antibiotics following positive pre-IVF semen culture. The presence of bacteria in semen samples used only for IVF (n = 90) did not reduce fertilization rates nor lead to infection of the embryo culture system. However, there was an increased incidence of significant culture of vaginal Gram-negative bacilli in patients with treated partners compared with untreated partners [15/52 (29{\%}) versus 5/48 (10{\%}), P < 0.05]. Thus antibiotic therapy in the male partner may increase the likelihood of inoculation of antibiotic-resistant pathogenic bacteria from the vagina into the embryo culture system during vaginal oocyte collection. In asymptomatic patients, microbiological screening of semen samples prior to IVF treatment and subsequent treatment with antibiotic therapy in those with positive cultures appears to be unnecessary and may be detrimental to IVF outcome.",
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Antibiotic treatment based on seminal cultures from asymptomatic male partners in in-vitro fertilization is unnecessary and may be detrimental. / Liversedge, N. H.; Jenkins, J. M.; Keay, S. D.; McLaughlin, E. A.; Al-Sufyan, H.; Maile, L. A.; Joels, L. A.; Hull, M. G.R.

In: Human Reproduction, Vol. 11, No. 6, 01.06.1996, p. 1227-1231.

Research output: Contribution to journalArticle

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T1 - Antibiotic treatment based on seminal cultures from asymptomatic male partners in in-vitro fertilization is unnecessary and may be detrimental

AU - Liversedge, N. H.

AU - Jenkins, J. M.

AU - Keay, S. D.

AU - McLaughlin, E. A.

AU - Al-Sufyan, H.

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AU - Joels, L. A.

AU - Hull, M. G.R.

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