Serum CA-125 values on the day of oocyte retrieval are not predictive of subsequent pregnancy with in-vitro fertilization.
In the clinical management of in-vitro fertilization (IVF) patients it would be very useful to know, before the embryo transfer, whether or not there is a significant chance of pregnancy in that cycle. If low, it would be better to freeze the embryos and postpone the embryo transfer to a subsequent cycle. For this reason, a retrospective study was carried out to investigate the correlations between the serum CA-125 values before embryo transfer and the clinical outcome of that IVF cycle. Women aged <40 years undergoing a complete infertility evaluation including laparoscopy and receiving gonadotrophin-releasing hormone analogue (GnRHa) suppression followed by purified follicle stimulating hormone (FSH) for IVF-embryo transfer were entered into the study. Ninety-seven cycles qualified for evaluation (26 pregnant and 71 non-pregnant cycles). CA-125 concentrations on the day of oocyte retrieval were significantly lower in the pregnant versus non-pregnant cycles in both non-endometriosis and endometriosis patients. To evaluate the existence of a cut-off value of CA-125 which would allow the prediction of a possible pregnancy with sufficient specificity and sensitivity, a receiver operating characteristic curve analysis was performed. This analysis demonstrated the absence of any predictive value of the subsequent pregnancy for CA-125 concentrations. For this reason, and in contrast with previous findings, CA-125 determinations before the embryo transfer in IVF patients do not appear to be a useful tool for clinicians to use in predicting the outcome of IVF in any given cycle.
Department of Obstetrics and Gynaecology, and Department of Clinical Physiopathology, University of Florence, Florence, Italy.
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Noci
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Maggi
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Biagiotti
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D'Agata
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Criscuoli
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Marchionni
D000328:Adult; D018394:CA-125 Antigen / Q000097:blood*; D004624:Embryo Transfer; D004715:Endometriosis / Q000150:complications; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000150:complications / Q000276:immunology / Q000628:therapy; D008297:Male; D009865:Oocytes; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012372:ROC Curve; D012189:Retrospective Studies; D013997:Time Factors
D018394:CA-125 Antigen