Patient's question:
I am 35 years old this year, and I am currently 2 months pregnant through in vitro fertilization, and it is twins. The children are very important to us, but because I had a history of candidiasis of the vagina and it always recurred, I got candidiasis of the vagina again just two months into my pregnancy. I am worried about it affecting the embryo and don’t know what medicine to use. I feel a heavy psychological burden. The local doctor prescribed me a medicine called "Lactic Acid Bacteria Vaginal Capsules," saying it would not affect the embryo within three months. However, I still don’t feel at ease, fearing it is a new drug with no clinical experience. I sincerely hope the experts can provide an answer. First question supplement: I would like to find a medicine that is safe for the embryoDoctor's answer:
Oral antifungal drugs are contraindicated during pregnancy. Actively identify and eliminate relevant triggers of the condition. The first choice is vaginal local antifungal drugs that have minimal impact on the fetus, require fewer doses, take effect quickly, and have a longer duration of action. The use of miconazole at therapeutic doses in the vagina during pregnancy does not increase the incidence of congenital malformations in the fetus or newborn. Vaginal local treatment has good safety.Clotrimazole suppository: It exerts its bactericidal effect by inhibiting the biosynthesis of ergosterol in yeast cells. Dosage: For first-time cases during pregnancy, place 500 mg into the vagina as a single dose. For recurrent cases, use one suppository every 3 days, for a total of 2 suppositories.
Miconazole suppository: It not only interferes with membrane biosynthesis and disrupts the fungal membrane system but also inhibits RNA synthesis, blocking the development of fungal cells. Dosage: 400 mg once daily, intravaginally, for 3 days, or 200 mg once daily, intravaginally, for 7 days.