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Dr. Andrew Rynne

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Semen analysis showed gram positive cocci presence. Took cipromax. Is this the cause for miscarriage?

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Dr. Dattaprasad

Infertility Specialist

Practicing since :2002

Answered : 673 Questions

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Posted on Wed, 30 Jan 2013 in Infertility Problem
Question: Hello my semen analysis showed gram positive cocci presence
the doctor prescribed me cipromax 500.
for 25 days with two tablets per day.
do you think this the reason we had miscarriage?
is there anything else I have to check?
I have the analysis but haven't found where to upload them
doctor
Answered by Dr. Dattaprasad 45 minutes later
Hi,
Presence of gram positive cocci in semen analysis is mostly due to contamination. This is rarely the sole cause for repeated miscarriages.
If you can give further details about miscarriages, I can guide you further in the matter.
Details required are:
1. Duration of pregnancy (preferably in weeks) at which miscarriage was detected.
2. Whether pregnancy was confirmed by home pregnancy test OR ultrasound?
3. If pregnancy was confirmed by ultrasound, whether fetal pole (mentioned as CRL in millimeters) was present?
4. Was heartbeat documented on ultrasound anytime during pregnancy?
Also the image you have uploaded is not clear. You can scan & upload better image.
It will be nice if you upload ultrasound reports of previous miscarriages.
You can also upload results of any other investigations done to know cause of miscarriages.
Awaiting your reply.
Regards.

Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Dattaprasad 2 days later
Hi Dr Please find attached my analysis.
For my wife :
1 one month after periods my wife did urine pregnancy test, this was positive but after one week she started bleeding again so she did blood test which was negative

2 - After that doctor prescribed folic acid + 2 injections of hormones to boost the egg

3 - at ovulation date the egg was 18mm than 22 so we did sexual intercourses

4 - my wife was prescribed cyclogest that she took since ovulation

5 - blood test showed high level of HCG after 2 weeks from ovulation.

6 - 7 weeks after last menstruation she started bleeding again; blood test showed that hcg is not as high as enough
Otherwise
should I continue taking the antibiotic for gram positive cocci?
it has been prescribed for me for 25 days
doctor
Answered by Dr. Dattaprasad 1 hour later
Hi,
Thanks for the reply.

The miscarriage you described appears to be biochemical pregnancy. (It's the pregnancy detectable by blood or urine hCG test, but aborts before the baby is visualized on ultrasound).

Normally 50% of pregnancies abort even before they are diagnosed. Most of such pregnancies are aborted due to genetic abnormalities in the developing baby.

Extensive investigations to know the cause of miscarriage are not warranted after the first miscarriage unless there is some other indication for it. (Like history of genetic disorders in family, female partner's age above 38 years, couple taking treatment for infertility etc.)

If none of the factors is present with you, there is no need to do extensive evaluation.

Regarding the presence of gram positive cocci in semen analysis, as I already mentioned, it's mostly due to contamination & rarely the sole cause of miscarriage.

If you have not yet started antibiotics, you can just repeat semen culture & mostly it will not contain any bacteria.

If you have already started antibiotics, it's better to continue for 3 weeks, as a repeat semen culture done after starting antibiotics will not give a true picture of infection.

Hope this answers your query. Let me know if you have other concerns.
If you do not have any clarifications, you can close the discussion and rate the answer.

Wish you good health

Regards

Above answer was peer-reviewed by : Dr. Shanthi.E
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