Usefulness of anti-factor VIII IgG ELISA in acquired hemophilia A follow-up.

Acquired hemophilia A (AHA) is a rare autoimmune bleeding disorder due to the presence of neutralizing autoantibodies directed against the coagulation factor VIII (FVIII). The reference method to detect and quantify anti-FVIII antibodies is the Bethesda assay (BA), but it presents some limitations such as a lack of sensitivity for low titers of inhibitor and the need for experienced laboratory. A commercially available ELISA detecting anti-FVIII antibodies has demonstrated excellent sensitivity and specificity. The aim of our study was to assess the performance of this ELISA for the detection of anti-FVIII IgG in AHA patients during the follow-up. In total, 11 acquired hemophilia A patients were recruited, and anti-FVIII antibody levels were monitored by BA and ELISA. Anti-FVIII IgG ELISA showed 100% sensitivity and 100% specificity, and it correlated with the BA. Discrepancies observed in 13.3% of cases were consistent with patients' biological evolution. All these data suggest the possible use of anti-FVIII IgG ELISA for both diagnosis and follow-up of AHA patients.

Impact of sleep on female and male reproductive functions: a systematic review.

OBJECTIVE: To evaluate the association of sleep parameters on female and male reproductive functions. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): Female and male individuals, either healthy or infertile. INTERVENTION(S): Relevant articles were identified according to the The Preferred Reporting Items for Systematic Reviews and Meta-analyses recommendations in the PubMed and EMBASE databases from January 1, 2000 to June 8, 2020. MAIN OUTCOME MEASURE(S): The association between sleep and ovary function, spermatic function, natural fertility, and in vitro fertilization (IVF) outcomes was assessed. RESULT(S): A total of 33 studies that looked at the association between sleep and either ovary function (n = 10), spermatic function (n = 12), natural fertility (n = 5), or IVF outcomes (n = 6) were included. Overall, female and male fertility, as well as IVF outcomes may be affected by short sleep duration, evening chronotype, or shift/night work schedules. However, the results were hardly comparable due to the heterogeneous study methodologies used. CONCLUSION(S): Sleep may be an original and innovative parameter to consider in the reproduction field. Further investigation is needed to elucidate how sleep and fertility are interrelated and how sleep might constitute a useful modifiable target in infertility management.