Surgical prophylaxis for assisted reproductive technology and infertility diagnostic procedures
Consider the principles for appropriate prescribing of surgical antibiotic prophylaxis (see Principles for appropriate prescribing of surgical antibiotic prophylaxis). See Assisted reproductive technology and infertility diagnostic procedures, and their requirement for surgical antibiotic prophylaxis for the indications for surgical prophylaxis for assisted reproductive technology and infertility diagnostic procedures.
Investigate patients for sexually transmitted infections (STIs):
- if they have symptoms of an STI
- before a transcervical procedure, including hysterosalpingography and hysterosalpingo-contrast sonography
- before a laparoscopic dye test (chromotubation).
If the results of investigations are positive, provide appropriate treatment for the STI to reduce the risk of postprocedural infective complications; ideally, treatment should be completed before the procedure.
For a printable summary table of the indications and regimens for surgical antibiotic prophylaxis, see here.
|
Procedures |
Is surgical antibiotic prophylaxis indicated? |
|---|---|
|
hysterosalpingography, hysterosalpingo-contrast sonography, laparoscopic dye test (chromotubation) |
ONLY IF the patient has a history of PID or tubal dilatation, or tubal damage is noted on visualisation [NB1] |
|
oocyte retrieval (donor or recipient) |
NO |
Note:
PID = pelvic inflammatory disease NB1: Surgical antibiotic prophylaxis is not required if the patient has been investigated, and treated as indicated, for sexually transmitted infections before the procedure. | |
If prophylaxis is indicated for patients who have not been investigated, and treated as indicated, for STIs before the procedure, use:
doxycycline 100 mg orally, 12-hourly for 5 days. The first dose of prophylaxis should be given before the procedure. surgical prophylaxis, assisted reproductive technology doxycycline