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Abstract

We report the first case of a man with normal fertility and mild hyper-androgenism who experienced a persistent negative sperm motility after treatment with clozapine. A 25-year-old female patient, with no other predisposing factors, was referred to our laboratory due to the presence of spermatogenic cells in a small ejaculate. The patient had no history of gastrointestinal disease or liver disease. Her semen analysis was negative for alanine transaminase, glucose, and other electrolytes, but her serum levels of vitamin B12 were within normal limits. Her serum levels of testosterone were within the normal range and she was treated with clozapine (30 mg/day) for 4 months. During her follow-up, no significant adverse effects on sperm motility were observed. We conclude that clozapine may be an effective treatment for infertility, but it may not be the first choice for many couples. It may be necessary to consider alternative treatments in patients with unexplained infertility who have not responded to conventional fertility treatments.

Similarities and differences

Similarities

In a study of 25 patients with unexplained infertility, we reported on the results of the first author’s (J. P.) sperm motility test and found a normal morphology. The results are shown in.

Differences

In our previous study, we reported that in the semen analysis of the first author’s sperm, sperm with normal morphology were detected in only 4.4% of the patients and in 2.6% of the patients with a mild positive sperm motility test. In our study, we have reported a positive result in only one patient and in one patient with mild positive motility. However, we did not report a positive result in the semen analysis. A possible explanation for this difference is that in our previous study, spermatozoa were not isolated in the semen analysis of the first author. The spermatozoa were not isolated in our previous study and the present study is the only study that reports the presence of spermatozoa in the semen analysis of the first author. Our previous study reported a negative result in all patients. The sperm motility test is usually performed by using a sample of semen obtained from the patient. A positive result is usually positive when a semen analysis is negative. However, a negative result is usually not detected when a semen analysis is positive.

Conclusions

The present study suggests that Clozapine (ciprofloxacin) may be effective for the treatment of infertility in men with mild hyper-androgenism. This could be due to its pharmacological action. The positive result in our study may be due to the effect of clozapine on spermatogenesis.

Citation:Wang J, Lee S, Park E, Park G, et al. (2021) A new approach for the diagnosis of male infertility. PLoS ONE 15(10): e0199097. https://doi.org/10.1371/journal.pone.0199097

Editor:F. E. C. Johnson, University of North Carolina, Chapel Hill, United States of America

Received:February 20, 2021;Accepted:June 14, 2021;Published:July 1, 2021

Copyright:© 2021 Wang et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability:All relevant data are within the paper and its Supporting Information files.

Funding:This work was supported by grants from the Korean Society for Promotion of Chemical Analyses, the Korea Health R& D Institute, and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests:The authors have declared that no competing interests exist.

1. Introduction

Fertility. Fertility is a common occurrence in both men and women. Men with male factor infertility usually have poor sperm counts or poor sperm motility. They usually do not ejaculate regularly or have poor sperm morphology (e.g., poor sperm motility or motility lacking certain sperm parameters).

The information in this report is not intended as a substitute for your primary healthcare provider's medical advice.

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RATINGS

Ciprofloxacin, 500mg, 250mg and 400mg

This product is a prescription medicine only. If you are pregnant, trying for a baby, or breastfeeding, you must only take this medicine when you think you may be pregnant. Do not give this medicine to anyone under the age of 18 years unless directed by the physician.

WARNING

CIPROFLOXACIN:

Not recommended for use in pregnant women

Do not use if you are pregnant

If you become pregnant while using this medicine, call your doctor or the nearest hospital. Do not use while breastfeeding

DOSAGE:

Adults:The typical dose for adults is one 250-mg tablet taken three times daily for 7-10 days, depending on the strength and duration of the treatment.

Children:The dose is based on weight and height. To correct your child's weight, your doctor will give you the lowest dose of medicine possible. The typical dose is 250-750 mg per day.

The typical dose for adults is one 125-mg tablet taken three times daily for 7-10 days, depending on the strength and duration of the treatment.

The typical dose is 125-750 mg per day.

Do not take this medicine for longer than directed. If your child has a history of allergy or hypersensitivity reactions, your doctor may change your dose to a maximum of 250-750 mg/day. Call your doctor for medical advice about side effects. If you have questions about dosing, dosage, or precautions, talk with your doctor.

TRAVEL FOR MEDICATION

ADULTS:The typical adult dose for children aged 4 years and older is one 500-mg tablet (250-mg) taken 3 times daily for 7 days, depending on the strength and duration of the treatment. The typical dose for adults is one 125-mg tablet (250-mg) taken 3 times daily for 7-10 days, depending on the strength and duration of the treatment. The typical dose for children aged 4 years and older is one 125-mg tablet (250-mg) taken 3 times daily for 7 days, depending on the strength and duration of the treatment. The typical dose for children aged 5 years and older is one 125-mg tablet (250-mg) taken three times daily for 7 days, depending on the strength and duration of the treatment. The typical dose for children aged 4 years and older is one 250-mg tablet (250-mg) taken three times daily for 7 days, depending on the strength and duration of the treatment.

The typical dose for adults is one 125-mg tablet (250-mg) taken three times daily for 7-10 days, depending on the strength and duration of the treatment.

CHILDREN:The typical dose for children aged 4 years and older is one 500-mg tablet (250-mg) taken three times daily for 7-10 days, depending on the strength and duration of the treatment. The typical dose for children aged 4 years and older is one 250-mg tablet (250-mg) taken three times daily for 7-10 days, depending on the strength and duration of the treatment.

Ciprofloxacin eye drops are one of the most widely used drugs in the field of eye care. They are used in various clinical scenarios, including:

A typical patient will receive the Ciprofloxacin eye drops as a single dose, with or without a meal, depending on the severity of the condition being treated. The typical dose of Ciprofloxacin eye drops is 0.5 mg/ml, 0.25 mg/ml, 1.5 mg/ml, 2.5 mg/ml and 5 mg/ml. This single dose is given every 4-6 hours, as prescribed by the prescriber. It is important to note that these doses will depend on the patient’s age and the type of eye care they are being treated for.

Uses of Ciprofloxacin Eye Drops

The typical indications for Ciprofloxacin eye drops are:

1. Doses for acute (eye-related) infections

A typical dose of Ciprofloxacin eye drops is 2.5 mg per day, with or without a meal. The dose can be administered by a healthcare provider, but it should be noted that Ciprofloxacin eye drops may be prescribed for patients with a history of eye infections, such as those withbacterial keratitisorcatatonia. The dose should be adjusted to the individual patient’s needs to minimize side effects.

2. Doses for chronic (eye-related) conditions

The typical dose of Ciprofloxacin eye drops is 5 mg/dose, which can be divided into 2 doses. For chronic conditions, the typical dose is 5 mg/dose in the morning, and 2 mg/dose in the evening. For eye infections, the typical dose is 5 mg/dose in the morning and 2 mg/dose in the evening. For eye infections, the dose is prescribed by a healthcare provider.

3. Doses for post-op infections

The typical dose of Ciprofloxacin eye drops is 1.25 mg/dose, with or without a meal. The dose can be adjusted to the individual patient’s needs to minimize side effects. The dose should be adjusted to the patient’s body weight to reduce the risk of side effects.

It is important to note that these doses are not recommended for the treatment of other eye conditions or for chronic conditions, such as:

4. Doses for post-operative infections

The typical dose of Ciprofloxacin eye drops is 2.5 mg/dose, which can be adjusted to the individual patient’s needs to minimize side effects.

5. Doses for recurrent (non-infectious) eye conditions

6. Doses for eye-related conditions

The typical dose of Ciprofloxacin eye drops is 2.5 mg/dose, which can be adjusted to the patient’s body weight to reduce the risk of side effects. The dose should be adjusted to the patient’s body weight to minimize side effects.

7. Doses for post-operative conditions

The typical dose of Ciprofloxacin eye drops is 1.5 mg/dose, which can be adjusted to the patient’s body weight to reduce the risk of side effects.

It is important to note that these doses are not recommended for the treatment of other eye conditions, such as:

8. Doses for oral or eye-related infections

The typical dose of Ciprofloxacin eye drops is 1.