zithromax and Infertility

To determine whether prophylactic azithromycin is associated with the vaginal bacterial microbiome and clinical outcomes in subfertile women undergoing in vitro fertilization (IVF).. Prospective exploratory cohort study.. Single academic fertility center.. Subfertile women aged 18-43 years undergoing their first IVF cycle and fresh embryo transfer.. Primary exposure to prophylactic azithromycin (1 g orally) once at baseline.. The primary outcome was the effect of azithromycin on the vaginal microbiome compared with a no-azithromycin group at 3 time points throughout the IVF cycle (baseline, retrieval, and embryo transfer). The secondary outcomes were associations of vaginal bacterial communities with clinical outcomes.. A planned a priori exploratory cohort of 27 subjects (12 in the azithromycin treatment group and 15 in the no-azithromycin group) contributed 79 vaginal swabs for the analysis as part of an ongoing randomized, controlled noninferiority trial. No specific taxa were associated with azithromycin or pregnancy at any time point. Azithromycin did not affect alpha diversity or community stability. Although there were trends of a lower bacterial load and higher percentage of. Prophylactic azithromycin at baseline is not associated with changes in vaginal bacterial communities. Bacterial community features at the time of embryo transfer are associated with pregnancy. Bacterial community structures at baseline are not predictive of those at the time of embryo transfer.. NCT03386227.

Topics: Anti-Bacterial Agents; Azithromycin; Cohort Studies; Female; Fertilization in Vitro; Humans; Infertility; Lactobacillus; Pregnancy; Prospective Studies

The infertility defined as the incapacity of the people to conceive a child in a given period, usually of 1-2 years of sexually unprotected relations, represents a major dysfunction of the genital apparatus. Its frequency is estimated at 10-15% of the couples at the reproductive age. The incidence of sterility is high, a couple out of 10 being sterile. The conjugal sterility is a phenomenon representative for the couple; the woman is responsible for it only in 35-40% of the cases, in 40% of the cases, the male factor is involved. In 20% of the cases, mixed factors are met, both feminine and masculine, and in 5-10% of the cases, the causes cannot be detected. From the multitude of causes of infertility, the infectious factor plays an important role, the Chlamydia infections being lately blamed in the etiology of sterility. The infections due to Chlamydia Trachomatis (CT) represent the most frequent sexually transmitted diseases, which, most of the times lead to sterility. Taking into account the widespread of this bacterium in the sexually active population, the effective treatment of the CT infection is very important. We have selected 200 cases with PID genital infection in the study. All the selected patients had at least 2, 3 and more than 3 inflammation recurrence episodes, this way being considered cases with medium and severe forms of disease. All these selected patients had at least 2, 3 and more than 3 episodes of inflammation recurrence, this way being considered medium and severe disease cases. In conclusion, there is a high clinical efficiency of the azithromycin treatment in PID case.

Topics: Anti-Bacterial Agents; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Female; Humans; Infertility; Male; Pregnancy

Ureaplasmas have been implicated in a variety of clinical conditions. However, only certain serovars of ureaplasmas are disease associated. Only a few classes of antimicrobial agents are available for the treatment of mycoplasmal infections in humans. Increase of resistance of genital mycoplasmas to antimicrobials has been reported worldwide. The aim of the present study was to determine the occurrence of Ureaplasma serovars in patients with infertility and genital tract infections with polymerase chain reaction (PCR)-based serotyping. The antimicrobial susceptibilities of Ureaplasma spp. and Mycoplasma hominis were also assessed to determine the most suitable treatment strategy.. Sexually active adults (n=147) with symptoms of genital tract infections and 115 infertile women were enrolled. Endocervical swabs from women and urethral swabs from men were subjected to culture and multiplex PCR for detection of genital mycoplasmas. Serotyping of Ureaplasma was done by PCR and antimicrobial susceptibility to doxycycline, azithromycin, josamycin and ofloxacin was done by microbroth dilution method.. Ureaplasma was detected in 25.8 per cent patients with genital tract infections and 20.8 per cent in infertile women. Serovar 3/14 was the most frequent isolate followed by serovar 1 and serovar 6. The majority of Ureaplasma isolates were susceptible to doxycycline (91%) and josamycin (86%) followed by ofloxacin (77%) and azithromycin (71%). All the isolates of M. hominis were uniformly susceptible to doxycycline, josamycin and ofloxacin.. The predominance of Ureaplasma serovar 3/14 suggests their possible pathogenic role in genital tract infections and infertility. For empirical treatment, doxycycline could be the drug of choice for genital mycoplasmas.

Topics: Adult; Anti-Infective Agents; Azithromycin; Doxycycline; Female; Humans; Infertility; Josamycin; Male; Microbial Sensitivity Tests; Ofloxacin; Polymerase Chain Reaction; Reproductive Tract Infections; Serotyping; Species Specificity; Ureaplasma; Ureaplasma Infections