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.
Noci
I
I
Department of Obstetrics and Gynaecology, and Department of Clinical Physiopathology, University of Florence, Florence, Italy.
Maggi
M
M
Biagiotti
R
R
D'Agata
A
A
Criscuoli
L
L
Marchionni
M
M
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