Reproductive Emergencies

Pregnancy Outcome Following Antibiotic Lavage and
Intravenous Antibiotic Combination Therapy
After Primary or Multiple Failed IVF Cycles

Patient's ID	Chlamydia	Patient's Age	Number of Failed Cycles	Repeat IVF	Pregnancy Status
1	+	37	1	Yes (1)	Delivered
2	-	43	5	Yes (1)	Failed
3	-	43	1	Yes (1)	Delivered
4	-	42	3	Yes (1)	Delivered
5	-	31	1	Yes (2)	Delivered
6	-	34	2	Yes (2)	Failed
7	+	39	6	Yes (2)	Failed
8	+	38	3	No	Delivered/SPT
9	+	41	4	Yes (2)	Failed
10	-	40	1	Yes (1)	Delivered
11	+	34	3	No	Delivered/SPT
12	+	35	1	Yes (1)	Delivered
13	+	36	4	Yes (1)	Delivered
14	-	39	1	Yes (1)	Delivered
15	-	39	3	Yes (2)	Failed
16	+	34	4	Yes (1)	EDC 5/14/05
17	+	40	3	No	Delivered/SPT
18	-	36	12	Yes (2)	EDC 8/20/05
19	-	40	6	Yes (3)	Failed
20	-	31	1	No	Failed
21	-	32	3	Yes (1)	Failed
22	-	40	5	Yes (2)	Failed
23	+	39	6	Yes (1)	Failed
24	-	43	6	No	Failed
25	+	46	1	No	Failed
26	-	34	4	Yes (1)	Failed
27	+	42	2	Yes (1)	Delivered
28	+	37	3	No	Failed
29	-	45	10	Yes (2)	Failed
30	+	37	2	Yes (1)	Failed
31	-	42	3	No	Failed
32	-	43	3	Yes (3)	Failed
33	-	44	1	No	Failed
34	-	38	3	Yes (2)	Delivered
35	-	39	4	Yes (1)	Delivered
36	+	40	2	Yes (1)	EDC 11/13/05
37	+	40	3	Yes (1)	EDC 11/05
38	+	35	2	Yes (2)	Failed
39	-	44	1	Yes (1)	Failed
40	-	38	3	Yes (1)	Delivered
41	-	36	3	No	Failed
42	-	35	1	No	Delivered/SPT
43	+	34	2	No	Failed
44	+	36	2	Yes (1)	Failed
45	+	39	3	Yes (1)	Failed
46	-	50	7	Yes (1)	Delivered
47	+	39	4	No	Failed
48	+	41	7	No	Failed
49	-	40	4	No	Failed
50	-	33	1	No	Failed
51	+	40	3	Yes (1)	EDC 8/05/05
52	+	39	2	Yes (1)	Delivered

Total Number of Patients: 52 (all primary infertility and had at least 1 previous failed IVF cycle)
Number of patients who returned for subsequent IVF cycles: 36
Number of patients who pregnant/delivered following subsequent IVF cycle: 19
Number of patients who did not go for subsequent IVF cycle: 16
Number of patients with spontaneous pregnancy: 4

Successful Deliveries

By age group:

<37: 10/5 (50%)

37-39: 10/5 (50%)

40-43: 12/8 (66%

>43: 3/1 (33%)

By number of previous trials:

1: 7/6 (85%)

2-4: 20/11 (55%)

>5: 8/2 (25%)

Chlamydia status before IV therapy:

52/24 (46%).

Out of 36 who went back for IVF 16 (44%) were positive.

Delivery for Chlamydia positive patients: 16/11 (72%).

Failed subsequent IVF cycles for Chlamydia positive patients: 16/4 (25%)

Three out of four patients who achieved spontaneous pregnancies post antibiotic therapy were originally Chlamydia positive.

Important points:

The less failed IVF cycles you had the more likely that my therapy will be followed by a successful IVF, suggesting an infectious cause of infertility that is aggravated through subsequent failed cycles.
The four spontaneous pregnancies make a strong case for using antibiotics first before resorting to IVF.
As I always suspected, age is not as significant an issue as it is currently believed.
Chlamydia seems to emerge as a very important pathogen. Regretfully testing is often not performed or if performed and positive reading given the subsequent antibiotic therapy is highly inadequate.
I cannot finalize the data until November 2005 when the last patient is expected to deliver. As data keep coming in I'll provide you with updates.
So far, however:
- No IUGR
- For all babies delivered total of 8 days in NICU for "observation"
- Cost benefit analysis of IVF and my antibiotic therapy favors the antibiotics