title: Evaluation of endometrial activin A secretion for prediction of pregnancy after intrauterine insemination.
abstract: 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.
authors.affiliation: Department of Pediatrics, Obstetrics and Reproductive Medicine, Section of Obstetrics and Gynecology, University of Siena, 53100 Siena, Italy. florio@unisi.it
authors.forename: Pasquale
authors.initials: P
authors.lastname: Florio
authors.forename: Luca
authors.initials: L
authors.lastname: Bruni
authors.forename: Letizia
authors.initials: L
authors.lastname: Galleri
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Reis
authors.forename: Lavinia E
authors.initials: LE
authors.lastname: Borges
authors.forename: Caterina
authors.initials: C
authors.lastname: Bocchi
authors.forename: Pietro
authors.initials: P
authors.lastname: Litta
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Leo
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: 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
chemical_list: C422405:activin A; D028341:Activins