Serum CA-125 levels in the second week after embryo transfer predict clinical pregnancy
János Urbancsek1, Erik E Hauzman, Ana R Lagarde
1First Department of Obstetrics and Gynecology, Semmelweis University, Faculty of Medicine, Budapest, Hungary. urbjan@noi1@sote.hu
Objective:
To correlate CA-125 concentrations in serum samples collected for routine hCG measurements 11 +/- 2 days after embryo transfer in relation to pregnancy and its outcome.
Design:
Retrospective study.
Setting:
University-based in vitro fertilization (IVF) program.
Patient(S):
One hundred and eighty-two consecutive pregnancies conceived after IVF or intracytoplasmic sperm injection, and 41 control cycles without pregnancy from the same patients.
Intervention(S):
None.
Main Outcome Measure(S):
Analysis of correlation between CA-125 concentrations and hCG and inhibin A levels. Predictive accuracy of these markers was compared by receiver-operating characteristic (ROC) analysis.
Result(S):
The CA-125 levels were statistically significantly higher in pregnant than in nonpregnant patients. Within pregnant cycles, CA-125 concentrations correlated positively with levels of hCG and inhibin A. The CA-125 levels were statistically significantly lower in preclinical abortions than in clinical pregnancies. No statistically significant difference was observed between early pregnancy losses and ongoing pregnancies or singleton and multiple pregnancies, respectively. The predictive accuracy of CA-125 measurements was statistically significantly lower than that achieved with hCG or inhibin A.
Conclusion(S):
Although CA-125 levels seem to be predictive of clinical pregnancy, they are not predictive of its outcome. Higher CA-125 concentrations may reflect higher endometrial receptivity but do not predict the number or viability of implanted embryos.
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