Initial Consultation

When a future patient is seeking our help for infertility or for the treatment of an infectious condition, the first step in establishing a patient-doctor relationship is going through the initial consultation. This is an in office or on the telephone conference that can take between one hour to 1 ½ hour long. During the conference Dr. Toth will take an in-depth history from the candidate relating to both medical and fertility events and will involve questions relating to parents/grandparents and siblings. The information gathered from the correctly answer questions will help Dr. Toth to assess the background to a condition and gives him an idea what best approach to take and assess the difficulty of a given condition. To schedule a time for this conference please write to us a short email by going to the “Contact Us” page of this website. Our office manager will respond to this email and provide you with detailed instructions how to proceed. Dr. Toth will need some information from you for review in advance before your visit. If you combine the consultation with the initial office visit, your time spent with us could be as long as 2 ½ hours.

Evaluation of the Microbial Profile of the Genital Canal

Testing for aerobic, anaerobic bacteria, Mycoplasma, Chlamydia trachomatis, trichomonas and yeast. The MacLeod laboratory had a long history of being one of the best laboratories in the greater New York Metropolitan area offering reliable and detailed microbiological profile of genital secretions. Three decades of excellent laboratory performance proved that bacteria free genital secretion taken from the male or from the female genital canal is an extreme rarity. When we encountered negative laboratory results, we suspected laboratory error. Several retrospective review studies from our laboratory however revealed one shocking discovery. The dominance of Chlamydia trachomatis became obvious in both samples obtained from infertile couples and in those collected from patients coming for the treatment of infections of female or male pelvic organs, including prostatitis. Our findings are in synchrony with those published by the CDC showing 8 to 10% yearly increase of chlamydia infection rate in the general population. Chlamydia can infect and compromise immune cells thus pave the way to any other bacterium to colonize a body cavity. Thus the finding of chlamydia in a disease process is of primary significance. Finding other bacteria, aerobic and anaerobic organisms we considered co-infections.

At this point we are confident that we have learned the entire clinical picture chlamydia infections can present both in the male and female genital organs. We became familiar with the laboratory and sonographic appearance of chlamydia infections and able to draw conclusive diagnosis. After our evaluation for the presence of chlamydia infection we use an antibiotic mixture with six antibiotics, three of which are active against chlamydia and the six together would cover any potential other bacterial pathogens.

Comprehensive Antibiotic Therapy

Between the early 1980s and today we have documented a close to fourfold increase in chlamydia infectious rate in both of our infertility population and in our prostatitis patients. We thus conclude that this organism is by far the most important pathogen not only in the genital canal but also behind many additional medical problems in the newborn baby. Our therapeutic approach has changed during the years accordingly. Rather than targeting individual bacteria without further evidence of their relationships to certain clinical pictures, we elected to target all, ever implicated genital track pathogens such as aerobic and anaerobic bacteria, Mycoplasma, the parasite Trichomonas and yeast like organisms with an antibiotic cocktail that has the mixture of six different antibiotics.  In this cocktail there are three antibiotics with spectrum against chlamydia. We also mixed antifungal medication in the cocktail.   This approach has paid off not only in terms of improving symptomatic pelvic infections both in the male and female population but giving us healthy full-term pregnancies with healthy newborns in our infertility population.

Hormone Tests

In the female: We have learned during our thirty years of treating infertile couples that secondary hormonal abnormalities in the females are almost always caused by an infection arriving through the uterine cavity to the ovaries causing low-grade infection and changes in normal hormone production. Sexual activity without barrier type birth control is the most frequent cause for bacterial infections reaching the ovaries. A significant number of women presenting in our clinic after failed IVF cycle exhibit abnormal hormone levels that developed after one or multiple stimulated cycles. Simple explanation for hormonal irregularities following failed IVF cycles is the fact that the excess level of hormones created in the female pelvis during overstimulation suppresses the local immune system. The bacteria flora that is present in the pelvis even before the first IVF attempt and was the real cause behind the woman’s so-called “unknown cause of infertility” will enjoy the immune suppressed environment, proliferates out of control, leads to ovarian infection and to the abnormal hormone levels. On a new patient we therefore are interested seeing pre-antibiotic-treatment, day three hormone levels, including FSH, LH and estradiol. In the middle of the cycle at the time of ovulation we also like to see a pretreatment estradiol value and finally on day 21 the progesterone level. These same hormones are retested following our comprehensive antibiotic regimens (see in the treatment section of this website). Secondary, infection caused hormonal abnormalities represents the easiest cases for a reversal with our antibiotic therapy.  

In the male: Abnormal hormone levels are most commonly discovered in congenital conditions related to chromosomal abnormalities. Secondary cause behind hormonal abnormality can be a pituitary tumor or physical trauma to the testicles. In general, males with abnormal hormone level are much more resilient to therapy than those in the female. Intra uterine damage to the testicles during embryonic development or to the pituitary/testes axis is resilient to therapies unless there is a distinct absence of one specific hormone. Severe inflammation of the testes (orchitis) can lead to damage to the Leidig (testosterone producing) cells and that can be supplemented with testosterone therapy.       

Fertility Drug Treatment of Ovulatory Disorders

We do not use fertility drugs such as clomiphene, Perganol, Metrodin, HCG or progesterone replacement therapy in our clinic. They are used primarily by IVF clinics. We are familiar with the side effects of these drugs and how to monitor hyper stimulation. Before referring a patient for an IVF procedure, we discuss all other available remedies/procedures for an infertile couple.

Evaluation and Treatment of Male Infertility

Whether it is an infertility condition or a single male coming to us for treating prostatitis symptoms, we find an infection by far the most important cause behind all male related problems. As I outlined above, similarly as I see it in the female patients the majority of the prostate problems are related to chlamydia infection. It is notable that incidence of prostatitis among males is woefully underreported.
Among males whom we examined as part of an infertile union a shocking discovery came to light: a high number of these males already suffered from prostatitis. Archaic therapies of the male factor infertility using hormonal stimulations with clomiphene or HCG injections were repeatedly described. Our clinical experience proved during the years that the male factor infertility cannot be expressed in pure numerical reports. The bacteria content of the seminal fluid and the damage those bacteria cause both on the sperm quality and inside the female tract are by far the overriding causes behind the male factor. In the prostatitis section of this website I’m going to return to the proper antibiotic therapy of the male.

Artificial insemination (AI)

Arthritic insemination, using the husband’s or donors’ concentrated sperm and artificially depositing it through the cervix into the uterine cavity is a procedure indicated only in extreme rare situations. In our opinion it is highly abused without any convincing scientific background of its superiority to normal intercourse. The most common situation that it aims to overcome is cervical factor infertility, a condition with sticky unfavorable, hostile cervical mucus.
We have learned that chronic infection of the cervix is by far the most common cause of cervical factor infertility, nature’s way of preventing additional bacteria that can attach to sperms to reach the higher female genital structures. In our opinion artificial insemination only bypasses nature’s barrier and pushes up bacteria into the uterine cavity. Comprehensive antibiotic therapy that includes cleaning out the cervical canal will cancel the need for artificial insemination.

Counseling

A counseling session has the same format as a consultation except it is focused on one specific aspect of the reproductive process.
Counseling and therapy offered for the treatment of premenstrual syndrome, postpartum depression and primary and secondary dysmenorrhea. Breakthrough research in our laboratory introduced us to therapies that permanently can cure teenagers’ dysmenorrhea and greatly improve premenstrual syndrome and postpartum depression. Similarly, our research has made breakthrough discoveries in the management of polycystic ovarian syndrome (PCO) and premature ovarian failure (POF).
Series of failed IVF cycles or pregnancies with adverse outcome such as recurring miscarriages are our expertise. Recent research on this website will introduce the reader to the pass we followed and to the success we’ve achieved in these fields.
 

IVF procedures

Our laboratory assumes a very critical posture toward IVF. It’s our firm belief that IVF is offered too many times for financial gains to too many desperate couples with often-false promises and with fabricated numbers for successful cycles.
IVF procedure is justified for an extreme select few patients
1.The fallopian tubes are either destroyed through infection or missing after pelvic surgery or previously surgically tied/removed for sterilization.
2. Practitioners attending to patients to be screened for rare chromosomal inherited diseases can argue for the validity of performing preimplantation genetic testing on IVF embryos to secure the birth of an unaffected child.
3.In male factor infertility when the cause is extreme law sperm count.
Our results show that the great majority of IVF failures are caused by an undiagnosed, asymptomatic genital tract infection. Our study proved that randomly selected patients with one or multiple previously failed IVF cycles will have an over 70% chance to achieve a successful pregnancy with their very first IVF cycle following our comprehensive antibiotic therapy. Beware when your pre-IVF diagnosis for the cause of your infertility is “Unknown Cause”. The chance is between 70 to 80% that you have an undiagnosed infectious cause behind the problem.

Follow up care

We offer follow up care for our pregnant patients throughout their pregnancies, and if infectious complications develop, we recommend additional antibiotic therapy. See above.

Therapy for benign prostatic hypertrophy.

Our clinic offers injection therapy for males with Benign Prostatic Hypertrophy (BPH). Due to the frequent association of chronic prostatitis with BPH, a suspicious rise in PSA levels can occur. We recommend intraprostatic antibiotic injections prior to undergoing a series of prostatic biopsies to rule out cancer. 

Telephone consultation

Out of town patients benefit from this service. A one hour telephone consultation is almost always sufficient to asses the most probable cause of a clinical problem and suggest the most expeditious therapy. The price of this consultation is $400, the same as the charge for a first office visit. If, at a later date, the patient visits us eventually, this fee will count as payment for the first visit.