title: [Retrospective evaluation of Toxoplasma gondii seropositivity in fertile and infertile women].
abstract: Toxoplasma gondii infection is associated with a wide spectrum of clinical pictures in man, changing from asymptomatic infection to severe central nervous system disease. It has been well documented that toxoplasmosis is of crucial importance especially for pregnant women and immunocompromised patients. In addition to the risks of gestation complications and congenital infections, it has been suggested that toxoplasmosis has some unfavorable effects on reproductive capacity in both men and women. The data obtained from limited studies performed in animal models as well as in infertile couples, have supported the relationship between toxoplasma and infertility. The hypothesis concerning infertility mechanisms due to T.gondii in females include development of endometritis and fetal rejection due to local release of T.gondii from latently located cysts in endometrial tissue on stimulation during plansenta formation; impaired folliculogenesis in ovaries and uterine atrophy and reproductive failure due to hypothalamic dysfunction as a result of chronic toxoplasmosis. The aim of this retrospective study was the comparative evaluation of toxoplasma seropositivity rates of fertile and infertile female spouses who were admitted to an in vitro fertilization (IVF) center in Ankara, between 2004-2009 period, from different geographical regions of Turkey. A total of 1314 women (mean age: 31.8 ± 5.6 years) were included to the study. In the study group, 376 (28.6%) were positive for T.gondii IgG, 5 (0.4%) were positive for IgG + IgM and 1 (%0.07) was positive only for IgM antibodies, while total toxoplasma seropositivity was 29.1% (382/1314). Of the 1117 evaluated couples, women with well-defined cause of infertility due to male factors have been grouped as fertile (n= 495) and the others were accepted as infertile (n= 622). Toxoplasma IgG seropositivity was found in 145 (29.3%) of fertile and in 179 (28.8%) of infertile women and the difference between the seropositivity rates was not statistically significant (p= 0.851). Comparison of seropositive and seronegative women in view of demographic characteristics revealed that seropositivity rate increased with age (mean ages were 33.0 ± 5.3 and 31.4 ± 5.6, respectively; p< 0.001); the rate was significantly higher in housewives than women with different occupations (31.4% and 25.7%, respectively; p= 0.003) and higher in women who inhabited in Mediterranean region than in Central Anatolia region (46.4% and 27.2%, respectively; p= 0.019). There were no statistically significant correlation between the seropositivity rates and abortion history and cause of infertility (p> 0.05). In conclusion, these data did not indicate a relationship between toxoplasmosis and female infertility, however advanced molecular, serological and clinical studies are needed for the confirmation of this hypothesis.
authors.affiliation: Ankara University Faculty of Medicine, Department of Medical Parasitology, Ankara, Turkey. gakarsu@yahoo.com
authors.forename: Gülay
authors.initials: G
authors.lastname: Aral Akarsu
authors.forename: Halil Atilla
authors.initials: HA
authors.lastname: Elhan
authors.forename: Cem
authors.initials: C
authors.lastname: Akarsu
mesh_terms: D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000469:parasitology*; D012189:Retrospective Studies; D014122:Toxoplasma / Q000276:immunology* / Q000302:isolation & purification; D014123:Toxoplasmosis / Q000453:epidemiology* / Q000503:physiopathology; D014421:Turkey / Q000453:epidemiology
chemical_list: D000913:Antibodies, Protozoan