Screening for Toxoplasma infection before infertility treatment
Janitschke, K., Stoffels, G., Schleyer, K., Kentenich, H.
Geburtshilfe und Frauenheilkunde 2002; 62: 465-469.
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Purpose: This study will try to give recommendations for an extended serological screening for women with Toxoplasma antibodies and the optimal time frame for conception during sterility treatment. Material and Methods: 964 women consulting an infertility clinic were serologically tested for Toxoplasma antibodies. Patients with Toxoplasma-IgG-antibodies submitted to further testing for Toxoplasma-IgM-antibodies (VIDAS TOXO IgM/bio Merieux). Positive sera for IgM were tested in IgG-Avidity (VIDAS TOXO IgG AVIDITY). Results: Out of all 964 women, 472 (49%) patients were tested positive for Toxoplasma-IgG-antibodies and were further screened for IgM-antibodies. 32 of those 472 women (6.78%) showed IgM-antibodies. Of those 32 women with IgM-positive-antibodies 29 were tested for IgG-Avidity. Low avidity was detected in 7 (24.1%) of 29 women with IgM-antibodies tested for avidity, which may indicate an acute infection. Conclusion: Screening for Toxoplasma infection should be a mandatory part before sterility treatment. An acute primary infection is a risk for the woman as well as the unborn child. Especially for children conceived through assisted reproduction the possibility of a vertical infection must be avoided. Screening for IgG- and IgM-antibodies can be completed with a further testing for IgG-Avidity. The suggested three-step screening procedure (IgG, IgM and IgG-Avidity) can help to minimize the risk of a prenatal Toxoplasma infection.