We prescribe the antibiotic Azithromycin before IVF and ICSI treatment as a precautionary step.

  • Your doctor will consider Azithromycin when he or she creates the management plan for your cycle.
  • The nurses will organize a prescription when you telephone the clinic with your ‘day1’. It is best to have the Azithromycin at least a week before egg collection, so we are recommending you take it the day of the first Gonal F or Puregon injection.
  • Unfortunately, Azithromycin is only funded when prescribed for proven infections and not prophylaxis – hence each prescription may attract a charge of about $20.
  • If you have any questions, please feel free to talk to your doctor’s nurse, or your doctor.

Why do we prescribe Azithromycin? To reduce the chance of the bacteria called Ureaplasma causing a miscarriage after IVF/ICSI treatment.

Ureaplasma is a bacteria commonly found in the reproductive tract of adults. It is seldom tested because it is so hard to grow in the laboratory, there are usually no
symptoms, and it doesn’t usually cause any disease.

However, two studies have suggested that Ureaplasma in men may increase the chance of miscarriage after ICSI treatment. This may be related to the way Ureaplasma attaches to sperm. Fertility Associates in Auckland asked men having a semen analysis at the clinic whether they would be happy to having their semen tested for Ureaplasma.

  • 18% of the men were positive, which suggests Ureaplasma is quite common among our patients.

It is not practical to screen men routinely for Ureaplasma because it is so hard to grow – we had to send every sample to the lab by taxi immediately after we received the semen sample!
So instead of testing people, we are offering couples the antibiotic Azithromycin before IVF and ICSI treatment as a precautionary step. Giving a drug when you don’t know
whether the person actually going to need it is called prophylaxis.

We screen all IVF patients - Not just those having ICSI

Many IVF clinics world-wide give prophylactic antibiotics to the man and woman before IVF and ICSI as part of the clinic’s preparation for treatment, so the concept is not new. Although Ureaplasma may impact ICSI more than IVF, we think it is sensible to offer Azithromycin to couples going ahead with IVF as well as ICSI since some cycles start as IVF but are converted to ICSI on the basis of sperm quality on the day of egg collection.