title: Serum CA-125 and inhibin B levels in the prediction of ovarian response to gonadotropin stimulation in in vitro fertilization cycles.
abstract: There is much controversy about the relationship between serum CA-125 levels during in vitro fertilization (IVF) cycles and ovarian function. To evaluate the prognostic value of serum CA-125 and inhibin B measurements in predicting ovarian response to gonadotropin stimulation, we compared the CA-125 and inhibin B levels of poor and normal responders on the first day of ovarian stimulation, on the day of ovulation induction (OI) and at oocyte pick-up. Sixteen patients with poor ovarian response (3 oocytes, serum estradiol (E2) 900 pg/ml at OI) in IVF/intracytoplasmic sperm injection cycles were matched with normal responders (6 oocytes, E2 1800 pg/ml) by age, spontaneous cycle day-3 follicle-stimulating hormone level and cause of infertility. Inhibin B concentrations were significantly lower at all three time points in poor responders, but CA-125 levels were not. No statistically significant correlation was found between CA-125 levels and any of the clinical or laboratory parameters examined. Thus, CA-125 measurements during stimulation are not useful in predicting or identifying poor ovarian response to gonadotropin stimulation in IVF cycles. The lack of difference in CA-125 concentrations between poor and normal responders and lack of correlation with E2 or inhibin B levels suggest that ovarian steroidogenesis and other granulosa cell functions do not influence the production of CA-125. Inhibin B, however, seems to predict ovarian response as early as at the start of stimulation.
authors.affiliation: First Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: János
authors.initials: J
authors.lastname: Urbancsek
authors.forename: Erik E
authors.initials: EE
authors.lastname: Hauzman
authors.forename: Akos
authors.initials: A
authors.lastname: Murber
authors.forename: Ana R
authors.initials: AR
authors.lastname: Lagarde
authors.forename: Thomas
authors.initials: T
authors.lastname: Rabe
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Papp
authors.forename: Thomas
authors.initials: T
authors.lastname: Strowitzki
mesh_terms: D000818:Animals; D018394:CA-125 Antigen / Q000097:blood*; D016022:Case-Control Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006062:Gonadotropins / Q000494:pharmacology*; D007265:Inhibins / Q000097:blood*; D010053:Ovary / Q000187:drug effects* / Q000502:physiology; D010062:Ovulation Induction; D020554:Sperm Injections, Intracytoplasmic
chemical_list: D018394:CA-125 Antigen; D006062:Gonadotropins; C422364:inhibin B; D004958:Estradiol; D007265:Inhibins; D005640:Follicle Stimulating Hormone