Antibiotics for infertility?

  Hello:
         Our situation is this: My husband has is his SA 8 PH High viscosity and low citric acid, his count always have been low, so has his motility, he  was prescribed Cipro 500 last month for 10 days, his count went high, but after leaving it again down. Now his Dr says to take it a month, he has been on it 3 weeks and we did a IUI and his count was great. My question is why is the antibiotic workking if no bacteria was found in a culture semen? How long can he be on antibiotics? We are afraid of leaving it now.  What does it means his citric acid is low? Is always 100 and must be 400.  It means a prostate problem?
  Well thanks for the help!     Lydia
                      

[hfhs M.D.-AK]

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Dear Linda,
Conventional semen analysis is an indirect assessment of fertility potential. INTERPRETATIONS MUST TAKE INTO ACCOUNT THE VARIABILITY BETWEEN SAMPLES.
Treatment with antibiotics in the case of infertility is an empiric therapy aimed a treating an occult(suspected) infection.  The course of antibiotics (Cipro) may or may not have helped with your husbands sperm count.  In terms of the citric acid content in the semen, this is a minor parameter found in studies to have little or no clinical significance.  The main parameters that should be evaluated are:
Ejaculate volume- 1.5-5.0 ml
Sperm density- >20 million/ml
Motility >60%
Forward progression >2 (scale 1-4)
Morphology >60% normal
You also mentioned that your husbands ejaculate had  a high viscosity, this is important because it might signify a disorder of accessory gland function.(Prostate or Seminal Vesicle)  This may affect the accuracy of the assessment of both sperm density and motility.  If there is associated clumping on a post coital test, this may suggest an inflammatory or immunologic process.(Infection)
The normal pH is 7.4-7.8 and your husband