Effect of antibiotic therapy on interleukin-6 in fresh semen and postmasturbation urine samples of patients with chronic prostatitis/chronic pelvic pain syndrome.

OBJECTIVES: To investigate the effect of antibiotic therapy on interleukin (IL)-6 in fresh semen and postmasturbation urine samples of patients with chronic prostatitis or chronic pelvic pain syndrome (CP/CPPS). METHODS: A total of 128 patients with CP/CPPS prospectively underwent the evaluation of IL-6 in fresh semen and postmasturbation urine samples. At 6 weeks after 4 weeks antibiotic therapy, the IL-6 levels were re-evaluated. RESULTS: Of the 128 patients, 109 (85.2%) were available for our analysis. Of the 109 patients, 72 (66.1%) met the criteria for National Institutes of Health (NIH) classification for inflammatory CP/CPPS (type IIIa) and 37 (33.9%) met the NIH criteria for noninflammatory CP/CPPS (type IIIb). Before antibiotic therapy, 86 patients (78.9%), irrespective of NIH classification, had an increased IL-6 level in fresh semen; 64 (88.9%) patients with CP/CPPS type IIIa and 22 (59.5%) with type IIIb CP/CPPS had increased IL-6 levels. After 4 weeks of therapy, a significant reduction was found in the IL-6 level, with only 44 (40.4%, P = .009) patients showing an increased IL-6 level: 34 patients with type IIIa (47.2%, P = .0000) and 10 with type IIIb (27.0%, P = .0033). An increased IL-6 level was found in the postmasturbation urine sample in 37 patients (33.9%), irrespective of NIH classification: 28 (38.9%) with type IIIa and 9 (24.3%) with type IIIb. At 6 weeks after therapy, only 3 patients (2.8%, P = .000) had an increased IL-6 level: 2 with type IIIa (2.8%, P = .0000) and 1 with type IIIb (2.7%, P = .02). CONCLUSIONS: The IL-6 levels had decreased significantly after antibiotic therapy in patients with CP/CPPS, suggesting a bacterial inflammatory character. The determination of IL-6 in seminal plasma and postmasturbation urine samples is useful as an addition to the diagnostic test for the patient with CP/CPPS and as an efficacy marker for therapy.

Successful pregnancy resulting from in-vitro matured oocytes retrieved at laparoscopic surgery in a patient with polycystic ovary syndrome: case report.

Combined laparoscopic retrieval of immature oocytes and ovarian electrocautery represents a new management in patients with polycystic ovary syndrome (PCOS), one of the most prevalent endocrinopathies associated with anovulatory infertility. A 31-year-old para II presented with anovulatory, clomiphene-resistant PCOS, and a 6 year history of infertility. Conventional IVF treatment was abandoned in 1999 when she developed severe ovarian hyperstimulation syndrome (OHSS) following gonadotrophin stimulation. Sixteen oocytes were aspirated from both ovaries and collected in culture tubes containing a maturation medium. A total of three 2-cell embryos were transferred 48 h after ICSI. Two weeks after embryo transfer the urinary pregnancy test was positive and after another 2 weeks an ongoing singleton pregnancy with a fetal heartbeat was confirmed at transvaginal ultrasound examination. The combination of laparoscopy, in-vitro maturation and ICSI may open up new therapeutic strategies, even in patients without PCOS and regular menstrual cycles, undergoing laparoscopy for other causes of infertility such as tubal factors and endometriosis.