Antibiotic Prophylaxis for Gynecologic Procedures prior to and during the Utilization of Assisted Reproductive Technologies: A Systematic Review
Table 1
Summary of evidence pertaining to antibiotic prophylaxis regimens for gynecologic procedures prior to and during ART.
Procedure
Guidelines for antibiotic prophylaxis
Hysterosalpingography (HSG)
No prophylactic antibiotics in patients without history of pelvic inflammatory disease (PID) If HSG demonstrats dilated fallopian tubes, oral doxycycline 100 mg should be given twice daily for 5 days In patients with a history of pelvic infection, doxycycline should be given prior to procedure and continued if dilated fallopian tubes visualized
Saline infusion sonography
Routine administration of prophylactic antibiotics is currently not recommended, though it should be based on the patient’s individual risk of PID In patients with known hydrosalpinges, prophylactic antibiotics are recommended if the endometrial cavity must be assessed
Hysteroscopy
Routine antibiotic prophylaxis is not recommended
Laparoscopy
Antibiotic prophylaxis is not recommended for laparoscopic procedures that involve no direct access from the abdominal cavity to the uterine cavity or vagina If abnormal or dilated fallopian tubes are noted during chromotubation, postoperative prophylaxis with doxycycline should be considered
Oocyte retrieval
Antibiotic prophylaxis (2 grams intravenous cefoxitin) is suggested in patients with a history of endometriosis, PID, ruptured appendicitis, or multiple prior pelvic surgical procedures Antibiotic prophylaxis (2 grams intravenous cefoxitin) is suggested in oocyte donors
