Evaluation of endometrial activin A secretion for prediction of pregnancy after intrauterine insemination.
OBJECTIVE
To measure activin A concentrations in uterine washing fluid collected from women with couple infertility undergoing intrauterine insemination (IUI).


METHODS
Retrospective case-control study.


METHODS
Tertiary university center for women's care.


METHODS
Fifty women, of whom 25 became pregnant after up to three IUI attempts and 25 did not.


METHODS
Endocrine and clinical evaluation, semen analyses and hypo-osmotic swelling test, ovarian stimulation, endometrial thickness measurement by ultrasound, uterine washing fluid collection by sonohysterography, and IUI.


METHODS
Activin A measurement by enzyme-linked immunosorbent assay, receiver operating characteristics curve analysis, and pregnancy rates after IUI; sensitivity, specificity, positive and negative likelihood ratios of activin A, and endometrial thickness for pregnancy prediction.


RESULTS
Activin A was measurable in all samples evaluated, and the levels (mean +/- SEM) were statistically significantly higher in the pregnant (0.08 +/- 0.01 ng/mL) than in the nonpregnant (0.022 +/- 0.001 ng/mL) group. Activin A at the cut off of 0.04 ng/mL achieved a sensitivity of 76.0 % (95% CI, 54.9%-90.6%) and a specificity of 100% (95% CI, 86.2%-100%) as a single marker for prediction of pregnancy.


CONCLUSIONS
Activin A is secreted into uterine lumen; the levels in endometrial washing fluids were higher in women who subsequently became pregnant after IUI, so its measurement may be useful in predicting successful implantation.
Florio
Pasquale
P
Department of Pediatrics, Obstetrics and Reproductive Medicine, Section of Obstetrics and Gynecology, University of Siena, 53100 Siena, Italy. florio@unisi.it
Bruni
Luca
L
Galleri
Letizia
L
Reis
Fernando M
FM
Borges
Lavinia E
LE
Bocchi
Caterina
C
Litta
Pietro
P
De Leo
Vincenzo
V
Petraglia
Felice
F
D028341:Activins / Q000378:metabolism*; D000328:Adult; D001826:Body Fluids / Q000737:chemistry / Q000378:metabolism; D016022:Case-Control Studies; D010064:Embryo Implantation / Q000502:physiology; D004717:Endometrium / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007246:Infertility / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D007315:Insemination, Artificial / Q000379:methods; D009929:Organ Size; D011247:Pregnancy; D011258:Pregnancy Tests / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014599:Uterus / Q000378:metabolism
C422405:activin A; D028341:Activins