THE MEASUREMENT OF CA-125 AND PLACENTAL PROTEIN-14 IN UTERINE FLUSHINGS IN WOMEN WITH RECURRENT MISCARRIAGE - RELATION TO ENDOMETRIAL MORPHOLOGY

The concentrations of CA 125 and placental protein 14 (PP14) were meas ured in uterine flushings obtained throughout the luteal phase of the cycle from eight normal fertile women, The concentrations of both prot eins increased in a similar pattern throughout the luteal phase of the cycle, with the most dramatic increase occurring 6 days after their l uteinizing hormone surge (day LH +6), However, a greater variation in CA 125 concentrations was seen compared to that seen for PP14, The con centrations were compared to those obtained on day LH + 7 of the cycle from a group (n = 35) of women with recurrent miscarriage. The ranges in concentration of PP14 and CA 125 in the flushings of fertile and r ecurrent miscarriage patients were very similar, However, a greater pr oportion of women with recurrent miscarriage (55%) had low concentrati ons (<5 ng/ml) of PP14 than in the control group (12.5%) and the conce ntrations of PP14 in the uterine flushings were significantly less (P < 0.05) in women with recurrent miscarriage compared to the normal fer tile group, There was no significant difference in the concentration o f CA 125 in the uterine flushings between the two groups, Histological observation of the endometrial biopsy samples from recurrent miscarri age patients gave menstrual cycle datings that ranged from day LH +2.5 to LH +6.5 with retarded endometrium (<day LH +5) in 12 of 35 (34%) p atients, Of these 12 patients, 10 (83%) had low PP14 concentrations an d six (50%) had low CA 125 concentrations in their uterine flushings, In the recurrent miscarriage patients with histologically normal(great er than or equal to day LH +5) endometrial development, 10 out of 23 ( 43%) also had low PP14 concentrations and 8 out of 23 (35%) had low CA 125 in their uterine flushings, The results suggest that PP14 is bett er than CA 125 as a marker for endometrial function in this group of w omen, In some cases (52%) the low concentrations of PP14 in the uterin e flushings could be explained by retarded endometrial development but for the others the reduction in PP14 concentration in the uterine flu shing was not associated with retardation of endometrial development.