Infertility/Fertility/Ofloxacin Prescription

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QUESTION: My husband was prescribed Ofloxacin 200mg for 21 days to treat any possible infections that might have been having a negative influence on his fertility after several failed cycles of IVF.

Afterwards his fertility did improve and we conceived immediately during the following IVF cycle.

We are considering another child and this will fall approximately 12 months since his previous prescription.

Would it be prudent to arrange another prescription of Ofloxacin in advance of attempting to conceive again or would you assume that the original prescription would have had a permanent affect on his fertility?

Thanks

ANSWER: Hello Louise from the U.K.,

Ofloxacin is an antibiotic and not a magic infertility pill.  Without knowing what your husband's doctor was treating (sperm problem?#, I'm not sure if that is the reason why the IVF cycle worked.  It could have just been coincidental.  I would therefore not recommend taking an antibiotic for no reason.

The only reason I can think of why your doctor prescribed an antibiotic is if there were signs of a prostatitis in the semen analysis #this is manifest by increased white blood cells).  In that case, it is not a permanent condition and the antibiotic should have taken care of it.  Therefore the antibiotic would not be required again.  However, I doubt that this made a difference because sperm is washed prior to using it with IVF.  Did your husband have ICSI done? This is why I don't think the antibiotic was the reason why your IVF was successful the third time.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  I now provide personalized fee for service consultations/advice/direction via email and payable via Pay Pal.  If interested, contact me via my email at info@montereybayivf.com.  This service will allow you to have your own personal on-demand infertility expert.





---------- FOLLOW-UP ----------

QUESTION: Hello, thank you for your reply.

Unfortunately with all respect, you don't seem to be aware of the latest advancements, which is sadly quite typical.

I was hoping to save myself the expense of consulting with a specialist again when I'm sure I could get the prescription in good faith from a sympathetic general practitioner.

We have previously had three ICSI cycles with one embryo from a total of 39 good eggs and then two ICSI cycles with calcium ionophore achieving a total of 11 embryos from 22 good eggs. Most embryos arrested by day 3 and we had no pregnancy and no frozen embryos.

Then my husband was tested for reactive oxygen species and had a result of 58 when the normal level is less than 4. Reactive oxygen species are possibly produced from asymptomatic infections which is why Ofloxicin was prescribed.

My husbands ROS was reduced to 6 and the impact of a normal ROS on prognosis is reduced DFI and increased blastocyst formation. Improved blastocyst formation is statistically linked to better outcomes.

Our subsequent cycle with ICSI and calcium ionophore resulted in 13 good eggs, 8 embryos, 6 blastocysts, a viable pregnancy and two frozen embryos.

Therefore I would disagree with your opinion that Ofloxacin is just an antibiotic and not at least to some extent a magic infertility pill and that our improved outcome was simply coincidence.

I do thank you for your time in responding though. Obviously this is not a question an a further response is not required.

Answer
Hello Again,

Thank you for the reply and obviously you are more "expert" than I.  One experience does not a study make, nor can any conclusions be made.  Of course, I am a traditional science based Physician and expert in infertility after many years of study and practice.  I'm afraid that despite your disagreement with me, and your own conclusions regarding "radicals" there is no data substantiating that claim or treatment, at least not in standard medical practice.  

There are many opinions outside of main-stream medicine claiming to be the cure-all for infertility.  Curandera's talks about manipulating the uterine position by massage.  Massage therapists talk about increasing the blood flow to reproductive organ's.  Acupuncturists talk about increasing blood flow, nerve stimulation or chi to cure infertility.  Herbalists and Homeopaths all have their own remedies.  However, none have been sufficiently proven to become commonly used in infertility treatments, and believe me, my desire to help my patients get pregnant would compel me to use these treatments if they were sufficiently useful.  As it is I already offer Acupuncturists, low dose aspirin, CoQ10 and low dose heparin to my patients simply because there are some studies showing some benefit.  So I am not one to necessarily tow the scientific line.  However, your question was to an established expert in the field and I gave you my opinion based on scientific facts, take it or leave it.  If you are already an expert, then you don't need my opinion.  However, if that is what helps you to achieve your goal of a pregnancy, then by all means, go with it.  After all, I pray over all my patients at the time of embryo transfer because I believe there is a divine entity that can help even if science doesn't agree with that!

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  I now provide personalized fee for service consultations/advice/direction via email and payable via Pay Pal.  If interested, contact me via my email at info@montereybayivf.com.  This service will allow you to have your own personal on-demand infertility expert.

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Edward Joseph Ramirez, MD, FACOG

Expertise

I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience

I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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