Endometrial profilin 1: a key player in embryo-endometrial crosstalk / 대한생식의학회지

Objective@#Despite extensive research on implantation failure, little is known about the molecular mechanisms underlying the crosstalk between the embryo and the maternal endometrium, which is critical for successful pregnancy. Profilin 1 (PFN1), which is expressed both in the embryo and in the endometrial epithelium, acts as a potent regulator of actin polymerization and the cytoskeletal network. In this study, we identified the specific role of endometrial PFN1 during embryo implantation. @*Methods@#Morphological alterations depending on the status of PFN1 expression were assessed in PFN1-depleted or control cells grown on Matrigel-coated cover glass. Day-5 mouse embryos were cocultured with Ishikawa cells. Comparisons of the rates of F-actin formation and embryo attachment were performed by measuring the stability of the attached embryo onto PFN1-depleted or control cells. @*Results@#Depletion of PFN1 in endometrial epithelial cells induced a significant reduction in cell-cell adhesion displaying less formation of colonies and a more circular cell shape. Mouse embryos co-cultured with PFN1-depleted cells failed to form actin cytoskeletal networks, whereas more F-actin formation in the direction of surrounding PFN1-intact endometrial epithelial cells was detected. Furthermore, significantly lower embryo attachment stability was observed in PFN1-depleted cells than in control cells. This may have been due to reduced endometrial receptivity caused by impaired actin cytoskeletal networks associated with PFN1 deficiency. @*Conclusion@#These observations definitively demonstrate an important role of PFN1 in mediating cell-cell adhesion during the initial stage of embryo implantation and suggest a potential therapeutic target or novel biomarker for patients suffering from implantation failure.

Eupatilin treatment inhibits transforming growth factor beta-induced endometrial fibrosis in vitro / 대한생식의학회지

Objective@#Endometrial fibrosis, the primary pathological feature of intrauterine adhesion, may lead to disruption of endometrial tissue structure, menstrual abnormalities, infertility, and recurrent pregnancy loss. At present, no ideal therapeutic strategy exists for this fibrotic disease. Eupatilin, a major pharmacologically active flavone from Artemisia, has been previously reported to act as a potent inducer of dedifferentiation of fibrotic tissue in the liver and lung. However, the effects of eupatilin on endometrial fibrosis have not yet been investigated. In this study, we present the first report on the impact of eupatilin treatment on transforming growth factor beta (TGF-β)-induced endometrial fibrosis. @*Methods@#The efficacy of eupatilin on TGF-β–induced endometrial fibrosis was assessed by examining changes in morphology and the expression levels of fibrosis markers using immunofluorescence staining and quantitative real-time reverse-transcription polymerase chain reaction. @*Results@#Eupatilin treatment significantly reduced the fibrotic activity of TGF-β–induced endometrial fibrosis in Ishikawa cells, which displayed more circular shapes and formed more colonies. Additionally, the effects of eupatilin on fibrotic markers including alpha-smooth muscle actin, hypoxia-inducible factor 1 alpha, collagen type I alpha 1 chain, and matrix metalloproteinase-2, were evaluated in TGF-β–induced endometrial fibrosis. The expression of these markers was highly upregulated by TGF-β pretreatment and recovered to the levels of control cells in response to eupatilin treatment. @*Conclusion@#Our findings suggest that suppression of TGF-β–induced signaling by eupatilin might be an effective therapeutic strategy for the treatment of endometrial fibrosis.

Early gonadotropin-releasing hormone antagonist protocol in women with polycystic ovary syndrome: A preliminary randomized trial / 대한생식의학회지

OBJECTIVE: To prospectively evaluate the efficacy and safety of a fixed early gonadotropin-releasing hormone (GnRH) antagonist protocol compared to a conventional midfollicular GnRH antagonist protocol and a long GnRH agonist protocol for in vitro fertilization (IVF) in patients with polycystic ovary syndrome (PCOS). METHODS: Randomized patients in all three groups (early antagonist, n=14; conventional antagonist, n=11; long agonist, n=11) received 21 days of oral contraceptive pill treatment prior to stimulation. The GnRH antagonist was initiated on the 1st day of stimulation in the early antagonist group and on the 6th day in the conventional antagonist group. The GnRH agonist was initiated on the 18th day of the preceding cycle. The primary endpoint was the number of oocytes retrieved, and the secondary endpoints included the rate of moderate-to-severe ovarian hyperstimulation syndrome (OHSS) and the clinical pregnancy rate. RESULTS: The median total number of oocytes was similar among the three groups (early, 16; conventional, 12; agonist, 19; p=0.111). The early GnRH antagonist protocol showed statistically non-significant associations with a higher clinical pregnancy rate (early, 50.0%; conventional, 11.1%; agonist, 22.2%; p=0.180) and lower incidence of moderate-to-severe OHSS (early, 7.7%; conventional, 18.2%; agonist, 27.3%; p=0.463), especially among subjects at high risk for OHSS (early, 12.5%; conventional, 40.0%; agonist, 50.0%; p=0.324). CONCLUSION: In PCOS patients undergoing IVF, early administration of a GnRH antagonist may possibly lead to benefits due to a reduced incidence of moderate-to-severe OHSS in high-risk subjects with a better clinical pregnancy rate per embryo transfer. Further studies with more subjects are required.

The effect of Health Inequality Factors on Health Level of the Rural Elderly

PURPOSE: This study aimed to analyze the relationships between the factors affecting health levels of the elderly in rural areas. METHODS: Subjects were 257 elderly people residing in rural areas of six cities and Gangwon Province. Data was collected through questionnaires (demographic and socioeconomic status, social resources, health behaviors, physical environment, psychological tendency and general health levels) and was analyzed by using multiple regression and Sobel test. RESULTS: The demographic and socioeconomic characteristics of the subjects exerted statistically significant influence on their social resources, health behaviors, physical environment, and psychological tendencies. The demographic and socioeconomic characteristics, social resources, health behaviors, physical environment, and psychological tendencies, in turn, exerted a statistically significant influence on the health level. The social resources had mediating effects on the relationship between income, one of the demographic and socioeconomic characteristics, and health level. The residential environments had mediating effects on the relationship between income and health level. The psychological tendency had mediating effects on the relationship between income and health level. CONCLUSION: This study suggests that income is an important factor affecting health level among rural elderly people. In addition, social resources, health behaviors, physical environment, and psychological tendencies among them also affect health level, so it is necessary to make strategies to improve these factors.

Factors Influencing Professionalism in Male and Female Student Nurses / 한국간호교육학회지

PURPOSE: Nursing is regarded as a female-dominated profession. However, the number of Korean males entering the field of nursing is increasing. This study examines which of the following factors influence professionalism in male and female student nurses: area of nursing, gender identity, gender stereotypes, satisfaction with the field, emotional intelligence, and interpersonal relationships. METHODS: In total, 133 male and 293 female student nurses were selected from four Korean provinces between July 2013 and February 2014 to participate in this study. The data were analyzed with descriptive statistics, t-tests, chi2-tests of independence, and multiple regression analyses using SPSS/Win 20 software. RESULTS: In males, 47.4% of variance in nursing professionalism was accounted for by grades, interpersonal relationships, gender stereotypes, and satisfaction with the field. In females, 41.9% of variance in nursing professionalism was accounted for by satisfaction with the field, interpersonal relationships, area of nursing, age, emotional intelligence and grades. Common factors that influenced both genders included satisfaction with the field, interpersonal relationships and grades. CONCLUSION: Although males and females revealed no significant differences in overall mean scores of nursing professionalism, several factors influencing nursing professionalism did differ by gender. Therefore, gender-specific nursing educational and training programs may be necessary to promote professionalism among student nurses.

Effects of Atomoxetine on Hyper-Locomotive Activity of the Prenatally Valproate-Exposed Rat Offspring

A substantial proportion of patients with autism spectrum disorder (ASD) display hyperactivity as a comorbid symptom. Exposure to valproic acid (VPA) during pregnancy produces ASD-like core behavioral phenotypes as well as hyperactivity in offspring both in human and experimental animals, which makes it a plausible model to study ASD-related neurobiological processes. In this study, we examined the effects of two of currently available attention defecit hyperactivity disorder (ADHD) medications, methylphenidate (MPH) and atomoxetine (ATX) targeting dopamine and norepinephrine transporters (DAT and NET), respectively, on hyperactive behavior of prenatally VPA-exposed rat offspring. In the prefrontal cortex of VPA exposed rat offspring, both mRNA and protein expression of DAT was increased as compared with control. VPA function as a histone deacetylase inhibitor (HDACi) and chromatin immunoprecipitation experiments demonstrated that the acetylation of histone bound to DAT gene promoter was increased in VPA-exposed rat offspring suggesting epigenetic mechanism of DAT regulation. Similarly, the expression of NET was increased, possibly via increased histone acetylation in prefrontal cortex of VPA-exposed rat offspring. When we treated the VPA-exposed rat offspring with ATX, a NET selective inhibitor, hyperactivity was reversed to control level. In contrast, MPH that inhibits both DAT and NET, did not produce inhibitory effects against hyperactivity. The results suggest that NET abnormalities may underlie the hyperactive phenotype in VPA animal model of ASD. Profiling the pharmacological responsiveness as well as investigating underlying mechanism in multiple models of ASD and ADHD may provide more insights into the neurobiological correlates regulating the behavioral abnormalities.

Animal Models of Dementia

The discovery of new therapies for neurological disorders is especially predicated on the use of animal models both to identify new therapeutic targets and to carry out preclinical drug trials. Of primary concern to a neuroscience researcher is the selection of the most relevant animal model to achieve his or her research goals. Dementia is defined as the loss of mental processing ability, including communication, abstract thinking, judgment, and ultimately physical abilities. Alzheimer's disease (AD) is the most common cause of progressive decline of cognitive function in aged humans, and is characterized by the presence of numerous senile plaques and neurofibrillary tangles accompanied by neuronal loss. Vascular cognitive impairment encompasses vascular dementia (VD) and is the second most common cause of dementing illness after AD. Some, but not all, of the neuropathological alterations and cognitive impairment in AD and VD can be reproduced genetically and pharmacologically in animals. We review the recent progress in the development of animal models of AD and VD. Experimental animal models of AD included cholinergic dysfunction-, Amyloid b-peptide-, neurofibrillary tangles-, and presenilin-related animal models. We focused on brief global ischaemic insults, chronic global hypoperfusion, and vasculopathies as experimental models of VD. Preclinical research based on animal models is pivotal to our knowledge of underlying molecular mechanisms and the drug discovery pipeline for dementia aiming at the development of therapeutic strategies alleviating or preventing this devastating disorder.

The Associtation between Methylenetetrahydrofolate Reductase Gene Polymorphisms and a Risk of Spontaneously Aborted Embryos / 대한불임학회지

OBJECTIVE: This study was performed to understand the influence of the methylenetetrahydrofolate reductase (MTHFR C677T and A1298C) genotypes on the spontaneously aborted embryos. METHODS: DNA was extracted from tissue samples of 95 spontaneously aborted embryos and 100 samples of normal children randomly and 449 samples of normal adults were selected as the controls. MTHFR genotypes were determined by a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. RESULTS: The aborted embryo group had higher frequency of MTHFR 677CC type (p=0.014) and lower 677CT type (p=0.063) than the controlled child group. The frequency of MTHFR 677CT type was drastically lower than that of controlled adult group (p=0.032). In the MTHFR C677T/A1298C combination, 677CC/1298AC genotype of the aborted embryo was significantly higher (p=0.034) than that of controlled child group, but it was not statistically significant in controlled adult group (p=0.063). CONCLUSION: MTHFR 677CC and MTHFR 677CC/1298AC genotypes may represent genetic markers for the risk of spontaneously aborted embryos at least in Koreans.

Simultaneous bilateral tubal pregnancy following in-vitro fertilization and embryo transfer / 대한산부인과학회지

A case of simultaneous bilateral tubal pregnancy following in-vitro fertilization and embryo transfer is presented. On the 22 days after ET, the patient complained of low abdominal pain and vaginal spotting for one day and was suspected of left tubal pregnancy by transvaginal ultrasonography. However, laparoscopy revealed the bilateral tubal pregnancy and laparoscopic bilateral salpingectomy was performed. This unusual type of ectopic pregnancy must be kept in mind when evaluating a patient suspected of a possible early abnormal gestation after assisted reproductive technologies. It is critical to perform a close inspection of the abdomen, pelvis, and contralateral tube during surgery.

A Study of Clinical efficacy of GnRH Antagonist (Cetrorelix(R)) and GnRH Agonist for Controlled Ovarian Hyperstimulation / 대한산부인과학회지

OBJECTIVE: To compare the clinical outcomes of GnRH antagonist (cetrorelix(R)) with those of conventional GnRH agonist for down-regulation in assisted reproductive cycle. Materials and Method: Ninety-nine women undergoing IVF or ICSI were treated with either GnRH antagonist (cetrorelix(R)) or GnRH agonist (Lucrin(R)) for pituitary down regulation. The patient characteristics, basal hormone profile and IVF outcome were compared. RESULTS: There were no significant differences in age and duration of infertility between two groups. E2 (pg/mL)/LH (mIU/mL)/FSH (mIU/ mL) on the 3 day of menstrual period as a baseline were also not significantly different between two groups. The number of hMG amples administered (30.5+/-11.2 versus 47.6+/-16.4 ample/cycle) and the duration of stimulation (11.0+/-1.7 versus 14.1+/-2.2 days) were significantly lower in the cetrorelix(R) group. There were no significant differences in the fertilization and pregnancy rates, the number of embryo transferred, the number of mature oocyte and the number of embryo obtained between two groups. CONCLUSION: The cycles using an antagonist protocol shows a shorter duration of stimulation with comparable outcomes with few injections than those with an agonist protocol. GnRH antagonist can be effectively used as GnRH agonist for pituitary down regulation in IVF-ET cycles.

Contribution of Thymidylate Synthase Enhancer Region (TSER) Polymorphism to Total Plasma Homocysteine Levels in Korean Patients with Recurrent Spontaneous Abortion / 대한불임학회지

OBJECTIVES: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. METHODS: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. RESULTS: Total homocysteine level was significantly higher in MTHFR 677TT genotype (9.80+/-3.87 mumol/L) than MTHFR 677CC genotype (8.14+/-1.74 mumol/L) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA (8.42+/-2.65 mumol/L) and 1298CC (6.09+/-0.32 mumol/L; p=0.2058) and, TSER 2R2R (8.61+/-1.68 mumol/L) and 3R3R (8.05+/-2.81 mumol/L; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest (11.47+/-4.66 mumol/L) in individuals with TSER 3R3R (8.05+/-2.81 mumol/L) and MTHFR 677TT (9.80+/-3.87 mumol/L) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes (7.69+/-1.77 mumol/L) had lower plasma homocysteine levels than TSER 2R2R (8.61+/-1.68 mumol/L) and MTHR 677CC (8.14+/-1.74 mumol/L) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. CONCLUSION: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.

G769A Variation of Inhibin alpha -gene in Korean Women with Premature Ovarian Failure

Premature ovarian failure (POF) is menopause before the age of 40 years. The frequency of POF is about 1% of all women. Recently inhibin alpha gene (INHalpha) has been indicated as candidate in POF pathogenesis. Inhibin, a glycoprotein, is a gonadal hormone, which can inhibit the synthesis and secretion of pituitary follicle-stimulating hormone (FSH), which has an important role in the recruitment and development of ovarian follicles during the folliculogenesis. G769A variation of INH alpha, alanine, is highly conserved across species, and has an important role of its receptor binding. We screened a G769A transition in the INHalpha from the total population of the patients of 84 women with POF and 100 normal fertile women. We found no variation between the normal subjects and the POF patients. G769A variation of INHalpha is rare in Korea women with POF.

Accumulation of mtDNA Deletion (Delta mtDNA4977) showing Tissue-Specific and Age-Related Variation / 대한불임학회지

OBJECTIVES: Controversial arguments exists on both the case for and against on the accumulation of mitochondrial DNA (mtDNA) deletion in association to tissue and age. The debate continues as to whether this mutation is a major contributor to the phenotypic expression of aging and common degenerative diseases or simply a clinical insignificant epiphenomenon. The objective of this study was to determine whether the accumulation of mtDNA deletion is correlated with age-related and tissue-specific variation. MATERIALS AND METHODS: One hundred and fifty-seven tissues from blood, ovary, uterine muscle, and abdominal muscle were obtained from patients ranging in age from 31~60 years. After reviewing the clinical reports, patients with mitochondrial disorder were excluded from this study. The tissues were obtained at gynecological surgeries with the consent of the patient. Total DNA isolated from blood, ovary, uterine muscle, and abdominal muscle was amplified by two rounds of PCR using two pairs of primers corresponding to positions 8225-8247 (sense), 13551-13574 (antisense) for the area around deleted mtDNA and 8421-8440 (sense), 13520-13501 (antisense) for nested PCR product. A statistical analysis was performed by c2-test. RESULTS: About 0% of blood, 94.8% of ovary, 71.4% of uterine muscle, and 86.1% abdominal muscle harbored mtDNA deletion. When we examined the proportion of deleted mtDNA according to age deletion rate was 90% of ovary, 63.6% of uterine muscle, 77.7% of abdominal muscle in thirties and 100% of all tissue in fifties. CONCLUSION: The findings of this study suggest that the mtDNA deletion is varied in tissue-specific pattern and increases with aging.

Effect of Pentoxifylline on the ICSI Program Undergone in Severe Asthenozoospermia / 대한불임학회지

OBJECTIVE: The aim of this study was to evaluate the effect of Pentoxifylline(PF) on the conventional ICSI program undergone in severe asthenozoospermia. METHOD: Total 348 cycles of ICSI programs undertaken at CHA General Hospital from January, 1996 to September, 2000, were divided into two groups - injected with pentoxifylline-treated sperm(PFT, 204 cycles) or non-treated sperm(NPFT, 144 cycles) and the clinical results of PFT group were compared with those of NPFT. RESULTS: PF-treatment on sperm increased their motility of normozoospermia and severe asthenozoospermia. Fertilization rate of PFT group was higher than those of ICSI programs undertaken using sperm of NPFT(70.6% vs. 62.9%, p<0.01). And, ET and clinical pregnancy rates of PFT were slightly higher than those of NPFT(93.1%, 44.2% vs. 90.3%, 36.2%). CONCLUSION: These results showed that treatment of pentoxifylline has a beneficial role on selection of viable sperm in severe asthenozoospermia.

Analysis of the Gene Expression by Laser Capture Microdissection (III): Microarray Analysis of the Gene Expression at the Mouse Uterine Luminal Epithelium of the Implantation Sites during Apposition Period1 / 대한불임학회지

No abstract available.

Analysis of Androgen Receptor Gene in Korean Patients with Androgen Insensitivity Syndrome / 대한산부인과학회잡지

Androgen insensitivity syndrome (AIS) is a X-linked disorder of sexual differentiation resulting from defective androgen receptor (AR) function. Androgens are secreted by the testes of 46,XY individuals, but there is loss of target organ response to the hormone. The abnormalities of AR are due to defects in the AR gene, and many mutations causing AIS have been reported since the cloning of AR gene. In this study, we analyzed the AR genes in twelve Korean patients with androgen insensitivity syndrome: 9 patients with complete AIS and 3 patients with partial AIS DNAs were isolated from patients with AIS, and the coding region of AR gene was amplified by a polymerase chain reaction using 7 pairs of primers (exon B-H). Sequence analysis of the AR gene was performed using direct sequencing and single strand conformational polymorphism (SSCP). The AR gene mutations were identified in 7 out of 12 patients: 6 of 9 patients with complete AIS, and one of 3 patients with partial AIS. Mutations found were as follows: the point mutation (ATT->ACT) at position 680 of exon D, point mutation (TGG->TGC) at position 751 of exon E, point mutation (CAA->TAA) at position 792 of exon F, point mutations (CGC->TGC, GTG->ATG) at position 855 and 866 of exon G, and the deletion of 13 nucleotides (CGTATCATTGCAT) at position 840 of exon G, respectively. To the best of our knowledge, the point mutations found in exon D, exon E, and exon F, and the deletion in exon G have not been observed before. SSCP revealed bands with abnormal mobility in 10 out of 12 patients tested. Mutations were found 5 out of these 10 patients. The other two patients showed no abnormal band on SSCP, but showed mutations by direct sequencing. In conclusion, we have demonstrated the AR gene mutations, including three novel mutations, in Korean patients with AIS, and these abnormalities might be related to the pathogenesis of androgen insensitivity syndrome.

Intravenous immunoglobulin for patients with repeated failure of in vitro fertilization-embryo transfer / 대한산부인과학회잡지

OBJECTIVE: The implantation failure after embryo-transfer (ET) is a major continuing problem in in vitro fertilization (IVF). This study was undertaken to determine the effectiveness of intravenous immunoglobulin for treatment of individuals experiencing repeated unexplained in vitro fertilization-embryo transfer (IVF-ET) failure. METHODS: A total of nine consecutive infertile patients who failed to become pregnant after previous IVF-ET replacing at least three or more normal developed embryos each were included in our study. During the subsequent new IVF-ET cycle, each women received intravenous immunoglobulin 500mg/kg before the embryo transfer. RESULTS: Only one implantation occurred. There were no remarkable side effects. A specific effect of intravenous immunoglobulin for patients with repeated IVF-ET failure could not be demonstrated. CONCLUSION: High-dose intravenous immunoglobulin may not be useful for patients with repeated failure of embryo transfer.

Effects of uterine leiomyomas on pregnancy rate in ART treatment patients / 대한산부인과학회잡지

No abstract available.

A Case of Recurrent Pregnancy Loss Associated With Systemic Lupus Erythematosus / 대한산부인과학회잡지

Systemic lupus erythematosus(SLE) is a multisystem disorder with a peak age of onset in the second and fourth decades of life predominantly occuring in females who will usually have the potential to become pregnant. This female to male predominance is greatest during childbearing years approaching a ratio of 13:1, after the menopause it declines to a ratio of 3:1, the ratio also seen in prepubertal years. In practice, despite the higher prevalence of rheumatiod arthritis, pregnancy in SLE is the most common management problem confronting physician and obstetrician amongst the connective tissue disorders and it is particularly important as the outcome of pregnancy is more unpredictable in this disease. As well as having clinical consequences for the health of both mother and fetus, pregnancy in lupus provides a model for studying the importance of other biological phenomena characterizing the disease. For example, the transplacental passage of maternal antibodies to Ro(SSA) and La(SSB) and their strong association with the neonatal lupus syndrome suggests a pathogenetic role for these autoantibodies. Other relevant issues are feto-meternal immunological tolerance and hormonal interaction with the immune system. We have experienced a case of recurrent pregnancy loss associated with systemic lupus erythematosus. So we report this case with a brief review of literatures.

A Case of Toxoplasmosis Detected in Habitual Aborter / 대한산부인과학회잡지

Toxoplasma gondii, an intracellular coccidian protozoan, is the causative agent of toxoplasmosis, a widespread infection affecting various birds and mammals including humans. In immunocompetent hosts, the infection is usually asymptomatic and benign. Toxoplasmosis is either congenital or acquired. In general prenatal therapy of congenital toxoplasmosis is beneficial in reducing the ncy of infant infection. Therapies are based primarily on spiramycin because of the relative lack of toxicity and high concentration achieved in the placenta. Clindamycin is the standard drug for chemoprophylaxis in newborn infants, and is directed at preventing the occurrence of retinochoroiditis as a late sequel to congenital infection. The standard treatment for acquired toxoplasmosis in both immunocompetent and immunodeficient patients is the synergistic combination of pyrimethamine and sulphonamides. Toxoplasmic encephalitis is tbe most common manifestation of acquired toxoplasmosis in immunocompromised patients and if not treated is fatal. However, because of toxicity, the therapeutic efficacy of pyrimethamine sulphonamide combinations may be seriously limited in immunodeficient patients. We have experienced a case of toxoplasmosis during the workup of habitual aborter. So we report this case with a brief review of literatures.