Ask a doctor on the topic of Allergology

Gentamicin allergy and insemination

January 11, 2021 | 30,00 EUR | answered by

Dear Sir or Madam,

In October, I had an insemination with donor sperm. Unfortunately, I was not informed that the sperm was washed with gentamicin.

The day after the insemination, I experienced mild nausea. On the second day, a slight rash (small red, intensely itchy spots) developed on my wrists, which continued to spread until the 7th day. I visited my general practitioner, who prescribed Cetirizine once daily. On the 9th day after the insemination, my chest, genital area, and lower abdomen were covered with a rash (urticaria), I experienced night sweats, and extreme shortness of breath. I called an ambulance and was admitted to the hospital. I was given 250mg of Solu-Cortef, 1 ampule of Fenistil, and Pantoprazole 40mg.

I visited an allergist the following day, the rash was still present. In addition, I was prescribed 40mg of Loratadine daily. A week later, an epicutaneous test for gentamicin was positive (Type IV sensitization). My symptoms did not fully resolve until 3 weeks later.

Since all donor sperm is washed with gentamicin, the allergist recommended pre-treatment with Prednisolone 250mg IV, Dimenhydrinate 1 ampule IV on the day of insemination, followed by Prednisolone 50mg orally the next day, and Prednisolone 25mg orally on the 3rd day.

In the meantime, I have visited 3 more clinics to continue treatment there. The different reactions of the doctors have left me feeling very uncertain. Some had no issue with simultaneous cortisone administration, while others refused treatment altogether, citing reasons such as:

- the second allergic reaction could be more severe
- there could be delayed allergic reactions occurring weeks later

I am not sure what potential long-term effects were being considered (Stevens-Johnson syndrome?), and I wonder if these could be prevented by cortisone treatment, or if they can even be caused by mucosal contact in the uterus with gentamicin. On the other hand, I do not want to risk a potentially deadly allergic reaction.

I would appreciate a second opinion on whether another insemination can be performed with simultaneous administration of Prednisolone, and what allergic reactions could still occur to what extent...

Thank you,
Tina