Diagnostic testing - Measurement of specific IgE antibodies to seminal plasma proteins in your sexual partner’s seminal fluid.

Screening/Pre-Treatment - Desensitization to relevant seminal plasma proteins in your sexual partner’s seminal fluid determined to cause your symptoms.

[ Screening/Pre-Treatment] [ Invoice ] [ Payment Agreement ]

1. Screening/Pre Treatment  [ return to top ]
   We will work with you through your family physician, internist, allergist, or other physician. Your physician will be responsible for sending us your medical records and performing the pre-screening blood tests and cultures that we require prior to accepting you for treatment for seminal plasma allergy. We also will request follow-up blood tests and communications from your physician after we have completed your care.

   Patients who are accepted for care by our group receive that care during a 2-3 day stay in Cincinnati, Ohio. Both conjugal partners must be present during the treatment. Treatment plans are usually scheduled two-three months in advance, after the patient has been accepted for care by our group.

   Prior to acceptance for treatment, both the patient and the patient’s spouse or partner must complete a battery of pre-screening tests for infectious disease and send those results for our review. (See the attached sheet for these tests).

   When we have reviewed your questionnaire and medical record and received results of the attached tests, and the results are within normal limits or not clinically significant, we will contact you and your physician to schedule further evaluation and treatment.

   • Required pre-treatment evaluation should be conducted by your personal physician or allergy specialist.
     
   
   
   • The following laboratory tests should be performed to rule out underlying causes.
     
     
     • Laboratory Orders for Human Seminal Plasma Hypersensitivity Pre-treatment Evaluation
       
   • Male (Semen Cultures)

     Candida – Culture and KOH prep

     Gardnerella – KOH prep/wet mount

     Trichomonas – KOH prep/wet mount

     Chlamydia – viral transport medium

     Mycoplasma – mycoplasma medium

     Gonorrhea – Thayer-martin agar plate

     HSV I and II – viral transport medium

     CMV – viral transport medium

     
     
   • Female (Vaginal/Cervical Cultures)

     Pap Smear

     Candida – Culture and KOH prep

     Gardnerella – KOH prep/wet mount

     Trichomonas – KOH prep/wet mount

     Chlamydia – viral transport medium

     Mycoplasma – mycoplasma medium

     Gonorrhea – Thayer-martin agar plate

     HSV I and II – viral transport medium

     CMV – viral transport medium

     HPV – DNA probe B211

     
     
   • Serologic Assessment (both Male and Female)

   CBC with differential	Renal, bone, liver panels
   ANA	TSH
   C3, C4 (Complement 3 & 4)	WSR
   Urinalysis	Routine Urine Culture
   RPR	HSV I and II
   CMV	HIV
   Hepatitis B Surface Antigen	Hepatitis C Antibody
   Hepatitis B Core IgM

   
   
   • Serologic Assessment (Male Only)

   PSA (prostate specific antigen)

   
   
   • For both male and female, a skin prick test should be performed to the following allergens:
     

   HISTAMINE	SALINE
   RAGWEED, SHORT	CAT
   TIMOTHY	BOX ELDER
   COTTONWOOD	ALTERNARIA
   PENICILLIUM	ASPERGILLUS FUMIGATUS
   OAK	CLADOSPORIUM
   DUST MITE	DOG
   **SEMEN

   
   The PRICK TESTS are to be interpreted 20 minutes after application.
   MEASURE AND RECORD ALL WHEAL AND FLARE REACTIONS IN MMs:
   
   ** This requires obtaining a fresh ejaculate from the spouse and letting it sit at room temperature to liquify for 30 minutes.  The specimen should then be spun down to remove the spermatozoa (the precipitant).  A prick test should then be performed on both the female and the sexual partner’s forearms using the donor’s seminal plasma supernatant which contains the seminal plasma proteins.  This is to confirm a systemic hypersensitivity response to seminal plasma proteins.
   

   If skin prick testing is not available, the following lab work should be substituted:

   1. Total IgE
   2. Serologic assessment of specific IgE antibodies to the above allergens (i.e., Immunocap…)
      
      
      
   • IN ADDITION
     From each male and female, collect four 10 ml serum separator tubes of blood (e.g., Vacutainer red top tube with separator gel and clot activator). Leave at room temperature until blood clots, about 1 hour, then centrifuge and remove serum. Serum can be stored at 4°C (refrigerator) up to 3 days prior to shipping.
     
     Please collect and send a 6 day pooled seminal fluid ejaculate from your sexual partner.  Seminal fluid should be collected on consecutive days in a sterile specimen container (store in the refrigerator each day until all samples are collected in the one container).  The serum tubes and seminal plasma samples should be packed to prevent leakage or breakage (i.e., in a sealed ziplock bag or biohazard bag in a styrofoam tube container and shipped using an overnight carrier.  Send the specimens on wet ice.  Please coordinate the collection of all specimens so they will be received earlier in the work week (i.e., Monday or Tuesday).
     
     
   • SHIP TO:
     Attn: Dr. Jonathan Bernstein
     Allergy Laboratory
     University of Cincinnati
     Medical Sciences Building
     231 Albert Sabin Way ML#563.
     Cincinnati, OH 45267-0563
     513-558-5533
     
     
   
   
2. Invoice for seminal plasma allergy  [ return to top ]
   
   • Cost for laboratory evaluation – include isolation of seminal plasma protein and serologic assays to measure specific seminal plasma allergic IgE antibodies – $2,000
     
     
   • Cost for clinical treatment – includes skin testing to seminal plasma allergens and desensitization to relevant seminal plasma proteins - $2,000
     
     
   • Total cost for evaluation and treatment: $4,000
     
     
3. Amendended Payment Agreement  [ return to top ]
   
   • Download form here.