We have studied approximately 23,000 pregnant women and their children from 14 institution located throughout the United States who participated in the Collaborative Perinatal Project. The children were followed for a period of 7 years. Serial serum specimens were available from the pregnant women and these were tested for antibody to toxoplasmosis using a micromodification of the indirect hemagglutination inhi-bition test (IHA). The patients with highest titers (≥1024) or fourfold rises to ≥ 256 by the IHA method were also tested for IgM antibody using indirect fluorescent test (IFA). Among the women tested, 38.6% had detectable antibody and a total of 2.2% of the women showed significant increases in antibody or were in the highest titer ranges. Based on this latter group and the IgM IFA tests, a “High Risk” group of 42 patients was identified. Two of the children had “probable” congenital toxoplasmosis and there were 3 stillbirths. Three other children had abnormalities including prematurity, hypotonia, or short leg which may or may not be related to toxoplasmosis. We also studied the entire population for evidence of abnormal findings which could be corelated with maternal antibody findings using a computer analysis. A total of approximately 240 first year and 300 seven year specific physical and developmental categories were considered. The only outcome indicated to be possibly important was an observed increase in micro-cephaly which was two-fold (.55% versus .24%) among the patients in the higher titer ranges.

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494 toxoplasmosis: maternal and pediatric findings in 23,000 pregnancies

Infertility is defined as the inability of couples to have a baby after one year of regular unprotected intercourse, affecting 10 to 15% of couples. According to the latest WHO statistics, approximately 50-80 million people worldwide sufer from infertility, and male factors are responsible for approximately 20-30% of all infertility cases. The diagnosis of infertility in men is mainly based on semen analysis. The main parameters of semen include: concentration, appearance and motility of sperm. Causes of infertility in men include a variety of things including hormonal disorders, physical problems, lifestyle problems, psychological issues, sex problems, chromosomal abnormalities and single-gene defects. Despite numerous efforts by researchers to identify the underlying causes of male infertility, about 70% of cases remain unknown. These statistics show a lack of understanding of the mechanisms involved in male infertility. This article focuses on the histology of testicular tissue samples, the male reproductive structure, factors affecting male infertility, strategies available to find genes involved in infertility, existing therapeutic methods for male infertility, and sperm recovery in infertile men.

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Some of the Factors Involved in Male Infertility: A Prospective Review

Global prevalence of latent toxoplasmosis in pregnant women: a systematic review and meta-analysis.

The global seroprevalence of Toxoplasma gondii among wild boars: A systematic review and meta-analysis.

Efficient health-care for pregnant women require accurate data on the prevalence of toxoplasmosis in pregnancy at global, regional, and country levels. In this systematic review with meta- and modelling-analysis, we searched PubMed, EMBASE, Web of Knowledge, Global Index Medicus, and Africa Journal Online to identify studies that reported enough data to compute the immunoglobulins (Ig) M or G seroprevalence estimates of Toxoplasma gondii in pregnant women up to December 31st, 2018, without any language restriction. The global and regional estimates were done using a random-effects meta-analysis. We included 250 studies with 723,655 pregnant women. The global IgM seroprevalence was 1.9% (95%CI: 1.7–2.3). At the regional level, Eastern Mediterranean had the highest IgM seroprevalence (4.1%, 95%CI: 2.8–5.5) and The Americas, the lowest (1.1%, 0.8–1.4), with a statistically significant difference between WHO regions (p < 0.0001). The global IgG seroprevalence was 32.9% (95%CI: 29.4–36.4). Among WHO regions, The Americas had the highest prevalence (45.2%, 95%CI: 33.4–53.4) and Western Pacific the lowest (11.2%, 7.8–15.1), with a statistically significant difference between regions (p < 0.0001). This study presents a high toxoplasma seropositivity in pregnant women at global, regional and country levels, with a consequential high risk of maternal and congenital toxoplasmosis.

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Global, regional, and country seroprevalence of Toxoplasma gondii in pregnant women: a systematic review, modelling and meta-analysis.

Background Toxoplasma gondii infection is one of the most prevalent infectious disease with worldwide distribution. Congenital toxoplasmosis is annually responsible for 1.20 million disability-adjusted life years around the world, but often it is overlooked many countries. Methods We performed an updated review to summarize the current researches on fetal, neonatal and maternal consequences of T. gondii infection and also adverse effects of toxoplasmosis on women reproductive organs. Results T. gondii infection could be cause of several abnormalities from hydrocephalus, microcephaly, deafness, abortion and still birth in fetal to psychomotor retardation, intellectual disability, hearing loss, slower postnatal motor development during the first year of life; and chorioretinitis, cryptogenic epilepsy and autism spectrum disorders in newborns. Moreover, this infection is related with neuropsychiatric disorders such as anxiety, schizophrenia spectrum disorders, depression, decreased weight, autoimmune thyroid diseases, self-directed violence, violent suicide attempts in mothers. This literature review emphasized that toxoplasmosis could be an important neglected factor endometritis, ovarian dysfunction, impaired folliculogenesis, ovarian and uterine atrophy, decrease in reproductive organs weight and reproductive performance in women. We reviewed role of the immunological profile such as pro-infiammatory cytokines and hormonal changes as main potential mechanisms related to this infection and development of maternal-fetal and reproductive disorders. Conclusion T. gondii is associated with several brain related disorders in both mothers and newborns, and also it is cause of several abnormalities in reproductive organs. Early diagnosis and treatment of the infection could be effective to significantly improve the clinical outcome.

An updated literature review on maternal-fetal and reproductive disorders of Toxoplasma gondii infection

Previous studies have demonstrated that latent toxoplasmosis is associated with neuropsychiatric disorders. We evaluated the correlation between Toxoplasma gondii infection and prenatal depression. In this case–control study, we enrolled 116 depressed pregnant women and 244 healthy controls. The Edinburgh Postpartum Depression Scale (EPDS) was used to evaluate the depression symptom severity in study participants. All participants were screened for the anti-Toxoplasma IgG by enzyme-linked immunosorbent assay. Seroprevalence of T. gondii did not significantly differ between the depressed pregnant women and healthy controls (OR = 1.4; 95 % CI = 0.9–2.19; P = 0.142). T. gondii IgG titer was significantly higher in depressed women (18.6 ± 10.9 IUs) than those in the control group (13.6 ± 8.1 IUs) (z = −5.36, P < 0.001). The T. gondii–positive depressed women showed a positive correlation of T. gondii IgG titer with the EPDS scores (r = 0.52; P < 0.01). The mean EPDS score was also significantly higher in the T. gondii–positive depressed women (20.7 ± 2.7) compared with the controls (18.36 ± 2.7) (P < 0.001). The results obtained from the current study revealed that T. gondii infection might affect susceptibility to depression and severity of depressive symptoms in pregnant women, particularly in those patients who have high antibody titers. Further study is required to fully elucidate the characteristics and mechanisms of this association.

M. Nourollahpour Shiadeh

Papers

An updated literature review on maternal-fetal and reproductive disorders of Toxoplasma gondii infection

Global prevalence of latent toxoplasmosis in pregnant women: a systematic review and meta-analysis.

The correlation between Toxoplasma gondii infection and prenatal depression in pregnant women.