Ready for IVF after exposure?

[incepdallas]

Hello Dr - I had an unprotected oral exposure with an escort 6 months ago. At 186 days which is 6 months after exposure, I tested negative for HIV, Herpes 1 and 2, Hepatitis B and C, Syphilis, Gonorrhoea and Chlamydia. One thing that scares me is that for Hep C testing, the value 1.5 months before was 0.0 and in the latest test is 0.1. Though anything below is 0.9 is negative, I am slightly worried about this. 2 weeks before the last test, I was on an international flight from London during which my spectacle fell on the toilet bowl itself ( not the seat). Though there was not much faecal matter on the bowl, there was definitely very little that I could see. I washed my spectacle thoroughly with the soap in flight and my hands as well. At that point, I had many cuts in my hand due to dryness. I have the following questions:

1. Based on the oral exposure, do I need any other tests? Me and wife are currently going though IVF. I have not had any symptoms in the last 6 months except little burning sensation while urinating, little ithcing on the scrotum and surrounding ( no sores though), right arm pain for last 1 month and 2 similar sores near penis. I had shown one such pore who said it was not an STD. Egg retrieval is scheduled next week. Please let me know sir.

2. Am I at risk for any other infection because of the flight incident - especially Hepatitis C or B? My test result makes me worried. I have had diarrhoea and stomach upset for close to 2 weeks since the flight incident and it is still there. Do I need to test myself for any infection? Do we need to stop the IVF process? Please let me know

Thanks for your time. Please think of worst case options before you answer as we are going through IVF

[H. Hunter Handsfield, M.D.]

You obviously found an unreliable (probably nonprofessional) website.  Hep C is blood borne, not transmitted by water, food, or intestinal contamination.

I stand by my previous reply and see no need to repeat myself. GI infections should pose no problem with IVF; and if you don't have nausea, vomiting, or diarrhea, you can be sure you have have no such infection.  But you should not be asking here.  If in doubt, ask the IVF physician or clinic.

That will be all for this thread.  Your worries have absolutely no basis in science.

[incepdallas]

Thanks Doctor for the prompt response. Before I wrap up, last few questions:

1. I read on the internet that I can get Hep C through toilet bowls. I am little worried as my test value is 0.1 and not 0.0 in the last test taken 2 weeks after the flight incident.I also had fatigue for last 2 weeks only in the evening. Can I completely ignore this and not have any test?

2. Also, other than STD and gastro infections, should I worry about anything else based on the flight incident that can interfere with the IVF? I

3. I assume gastro infections would not interfere with IVF. Please confirm.

4. I showed the sores to my physician who said it was not STD. I missed it in my last note. Lastly, for the oral sex, based on your response, I assume I DO NOT NEED ANY OTHER TESTING EVEN FOR ANY OTHER INFECTIONS / VIRUS / BACTIERA / MICROBE. Please confirm this. You are right. I went through an online portal.

Thanks and have a good Sunday.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

Oral sex is low risk for all STDs, and zero risk for many of them; you did not need many of the tests you had.  (My guess is you decided on the tests yourself, perhaps through an online lab service -- rather than relying on professional advice about it.  True?)

Hepatitis C is not transmitted by oral sex.  In fact, the ONLY proved sexual transmission route is through traumatic (bloody) rectal sex among gay men, and oral sex has never even been suspected or hinted as a transmission route.  You also were not at risk for HSV-2, hepatitis B, or chlamydia.  There was a small risk of gonorrhea and of herpes due to HSV-1.  But in any case, your negative results are reliable.

Nobody ever catches any STDs through contaminated toilets.  It is possible to catch various intestinal infections in contaminated toilets, but that's about all.

To your specific questions:

1) You do not need any other testing.  Even with no tests at all, your oral sex event would not have prevented safetly going ahead with IVF.

2) There was no STD risk from this or any other public toilet; see my comments above.

So all is well; you can go ahead with IVF without fear of any STD affecting the safety or success of the procedure.

Best wishes to you and your partner for successful conception--  HHH, MD