Evaluation of polymerase chain reaction on amniotic fluid for diagnosis of congenital toxoplasmosis

The present study assessed sensitivity and specificity of PCR targeting P30 gene in diagnosis of congenital toxoplasmosis using amniotic fluid samples. A total of 358 pregnant women in their first trimester of pregnancy, most of them were asymptomatic while the others suffered lymphadenopathy, fever and/or malaise. The serum sample from each woman was screened for Toxoplasma-specific ELISA IgM and IgG. Sero-negative females were then screened in 2[nd] and 3[rd] trimesters for sero-conversion. Amniocentesis was performed to seropositive and sero-converted women. Detection of Toxoplasma DNA in AF was done by animal inoculation and PCR targeting P30 gene. 85/358 women were sero-positive for Toxoplasma. Congenital infection was detected in 14/85 fetuses by MI. One mouse had tachyzoite in peritoneal exudate while other 13 showed cysts in histpathological sections of mice. PCR test targeting P30 gene was positive in 13 with additional four fetuses, only PCR gave positive results, and serologic follow-up of suspected fetuses [17] by IgM ELISA confirmed congenital toxoplasmosis. Sixteen cases of congenitally infected newborn were a symptomatic. One was clinically diagnosed [ventricular dilatation] by the ultrasound. The PCR drastically changed the diagnostic repertoire for prenatal diagnosis. The sensitivity and specificity of PCR targeting P30 gene on AF samples were 92.9% and 94.4% respectively while positive predictive value [PPV] was 76.5%, and negative predictive value [NPV] was 98.5%. Its disadvantages were in fact that negative result cannot exclude acute infection, and thus must be confirmed by MI and it is also an expensive technique

Prognostic factors for ovulatory response to letrozole in polycystic ovary syndrome

To evaluate prospectively the prognostic factors for ovulatory response to letrozole therapy in polycystic ovary syndrome [PCOS]. The IVF and Assisted Reproduction Center in Sana'a, Yemen. Thirty-three infertile patients with anovulatory PCOS were recruited. Ovulation was induced using 2.5 mg/day letrozole administered from day 3 to 7 of the cycle. When the dominant follicle reached a diameter > 18 mm, HCG 10.000 IU was given IM and timed intercourse was advised. Clinical and endocrinal parameters between responder and non-responder groups were analyzed. There was no significant difference between letrozole responders and non-responders as regards to the period and type of infertility, BMI, LH, FS H or LH/FSH ratio and E[2] levels. However, statistically significant differences were found with respect to patient age, menstrual pattern, hirsutism and fasting insulin levels between responders and non-responders to ovulation induction with letrozole in PCO patients. Response of the PCOS patients to ovulation induction by letrozole may be related to patient age, menstrual pattern, presence of hirsutism, and serum insulin levels