Department of Obstetrics and Gynecology, Diabetes Research Center, Infertility Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Iranian National Registry Center for Toxoplasmosis (INRCT), Imam Khomeini Hospital, Mazandaran University of Medical Sciences, P.O Box: 48166-33131, Sari, Iran.
Acta Parasitol. 2023 Jun;68(2):400-405. doi: 10.1007/s11686-023-00677-y. Epub 2023 Mar 30.
Some evidence reveled that chronic infection with Toxoplasma gondii (T. gondii) has recently been associated with infertility in human and experimental model. This baseline study aimed to investigate serological evidence of Toxoplasma infection among infertile women who admitted to the in vitro fertilization (IVF) clinic at Imam Khomeini Hospital, Mazandaran province, Sari, northern Iran.
In this retrospective (descriptive-analytical) study, all infertile women referred to the IVF clinic during 2010-2019 (10 years), constitute the study population. All data including demographic and some related characteristics were collected into a questionnaire and registered at the Iranian National Registry Center for Toxoplasmosis (INRCT) at the Mazandaran University of Medical Sciences, northern Iran. The existence of anti-Toxoplasma antibodies (IgG and IgM) was explored using a commercially available enzyme-linked immune sorbent assay (ELISA) kit (PishtazTeb, Iran), based on the manufacturer's protocol.
Of 520 infertile women, anti-T. gondii IgG, IgM and both IgG and IgM antibodies were detected among 342/520 (65.77%), 1/520 (0.19) and 4/520 (0.77) infertile women, respectively. Primary and secondary infertility was detected in 74.56% and 25.44% of IgG seropositive infertile women, respectively. Also, most of the IgG seropositive subjects had no history of abortion, polycystic ovary syndrome (PCO), fibroma, contraceptive use and varicocele in spouse as primary cause of infertility. Furthermore, serum levels of prolactin and antimullerian (AMH) hormones were normal in 81.29 and 80.12% of infertile women with anti- T. gondii IgG, respectively. There was also a statistically significant difference between the seroprevalence of Toxoplasma infection and these variables associated to primary infertility (P < 0.05).
According to the high prevalence (about two thirds) of chronic T. gondii infection among infertile women, particularly those with a history of abortion and primary infertility, it can be concluded that latent Toxoplasma infection pose a risk to infertile woman in the study area. Therefore, we advise that screening and treatment of Toxoplasma infection among infertile women must be favorably considered.
一些证据表明，刚地弓形虫（Toxoplasma gondii）慢性感染最近与人的不孕和实验模型有关。本基线研究旨在调查伊朗北部马赞达兰省萨里伊玛目霍梅尼医院体外受精（IVF）诊所就诊的不孕妇女弓形虫感染的血清学证据。
在这项回顾性（描述性分析）研究中，将 2010-2019 年（10 年）期间就诊于 IVF 诊所的所有不孕妇女作为研究人群。所有数据包括人口统计学和一些相关特征均被收集到一个问卷中，并在伊朗马赞达兰医科大学的 Toxoplasmosis 国家注册中心（INRCT）进行了登记。采用市售酶联免疫吸附试验（ELISA）试剂盒（PishtazTeb，伊朗）根据制造商的方案检测抗弓形虫抗体（IgG 和 IgM）的存在。
在 520 名不孕妇女中，342/520（65.77%）、1/520（0.19%）和 4/520（0.77%）的妇女检测到抗 T. gondii IgG、IgM 和 IgG 和 IgM 抗体。原发性和继发性不孕分别在 IgG 阳性不孕妇女中占 74.56%和 25.44%。此外，大多数 IgG 阳性患者的原发性不孕原因没有流产、多囊卵巢综合征（PCO）、纤维瘤、配偶使用避孕药和精索静脉曲张史。此外，在抗 T. gondii IgG 阳性的不孕妇女中，分别有 81.29%和 80.12%的催乳素和抗苗勒管激素（AMH）激素血清水平正常。Toxoplasma 感染的血清阳性率与原发性不孕之间的这些变量也存在统计学显著差异（P < 0.05）。
根据不孕妇女慢性 T. gondii 感染的高患病率（约三分之二），特别是有流产和原发性不孕史的妇女，可得出结论，潜伏性弓形虫感染对研究地区的不孕妇女构成风险。因此，我们建议应考虑对不孕妇女进行 Toxoplasma 感染筛查和治疗。
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