title: Early pregnancy factor (EPF) as a marker for detecting subclinical embryonic loss in clomiphene citrate-treated women.
abstract: OBJECTIVE
  A discrepancy exists between the apparently normal ovulation and the pregnancy rates in women treated with clomiphene citrate (CC). Our previous studies have indicated that immuno-suppressive "early pregnancy factor" (EPF) is a novel marker to detect subclinical embryonic loss in infertile women.
  
  
  METHODS
  In the present study EPF was used as a marker to detect subclinical embryonic loss in women treated with CC with/without gonadotropins. In some of the women treated with CC, conception was assisted by artificial insemination with husband's semen (AIH).
  
  
  RESULTS
  Our results have indicated that fertilization occurred (EPF + ve) in 47.7% (52/109) of women treated with CC with/without gonadotropins; 13.46% (7/52) retained the fetus and continued pregnancy till full term, whereas 78.9% (41/52) did not retain the fetuses. In the group where after stimulation, conception was assisted by AIH, fertilization was observed in 38.24% (26/68), retention in 11.54% (3/26) but subclinical embryonic loss was observed in 80.8% (21/26) cases.
  
  
  CONCLUSIONS
  Thus, our results have indicated that subclinical embryonic loss may account for some of the discrepancy observed between the apparently normal ovulation and the pregnancy rates in women treated with clomiphene citrate.
authors.affiliation: Institute for Research in Reproduction, Bombay, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Shahani
authors.forename: C L
authors.initials: CL
authors.lastname: Moniz
authors.forename: J S
authors.initials: JS
authors.lastname: Gokral
authors.forename: P K
authors.initials: PK
authors.lastname: Meherji
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D018835:Chaperonin 10; D002996:Clomiphene / Q000627:therapeutic use*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005313:Fetal Death / Q000175:diagnosis*; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000032:analysis*; D010062:Ovulation Induction; D010455:Peptides / Q000032:analysis*; D011247:Pregnancy; D011257:Pregnancy Proteins; D016037:Single-Blind Method; D013491:Suppressor Factors, Immunologic
chemical_list: D015415:Biomarkers; D018835:Chaperonin 10; D005300:Fertility Agents, Female; D006062:Gonadotropins; D007166:Immunosuppressive Agents; D010455:Peptides; D011257:Pregnancy Proteins; D013491:Suppressor Factors, Immunologic; C025124:early pregnancy factor; D002996:Clomiphene