Evaluation of serum CA 125 concentrations as predictors of pregnancy with human in vitro fertilization.
OBJECTIVE
To determine if CA 125, a product of human endometrium, may be an indicator of early endometrial function. To test this hypothesis we examined CA 125 concentrations before oocyte retrieval in IVF cycles.


METHODS
Retrospective data analysis of 111 consecutive IVF cycles.


METHODS
Tertiary care academic medical center.


METHODS
All women who received luteal leuprolide acetate (LA) suppression followed by hMG for IVF and had sera available for analyses were entered into the study.


METHODS
Serum CA 125 was measured in the previous luteal cycle, day 7 of hMG, day before, and day of hCG administration. Twelve other variables were analyzed.


RESULTS
Fifty-six cycles (47 women) qualified for evaluation and included 25 pregnant cycles (45%) and 31 nonpregnant cycles. Higher serum CA 125 concentrations were associated with pregnancy in both endometriosis and nonendometriosis subgroups. CA 125 values on the day of hCG administration were the best predictors of pregnancy, with levels > or = 16 U/mL having a sensitivity of 72%, specificity of 97%, and a positive predictive value of 95% for pregnancy. The other variables were not predictive of pregnancy.


CONCLUSIONS
With a LA and hMG stimulation protocol, increased CA 125 concentrations before retrieval are associated with very high pregnancy rates. The source(s) of the serum CA 125, although as yet undertermined, may be of endometrial origin. The study supports further evaluation of CA 125 concentrations in IVF as a preretrieval predictor of pregnancy.
Miller
K A
KA
Department of Obstetrics and Gynecology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, USA.
Deaton
J L
JL
Pittaway
D E
DE
D018394:CA-125 Antigen / Q000097:blood*; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008183:Luteal Phase / Q000097:blood; D011247:Pregnancy; D012189:Retrospective Studies
D018394:CA-125 Antigen; D006063:Chorionic Gonadotropin