EARLY-PREGNANCY FACTOR (EPF) AS A MARKER FOR DETECTING SUBCLINICAL EMBRYONIC LOSS IN CLOMIPHENE CITRATE-TREATED WOMEN

PROBLEM: A discrepancy exists between the apparently normal ovulation and the pregnancy rates in women treated with clomiphene citrate (CC). Our previous studies have indicated that immune-suppressive ''early p regnancy factor'' (EPF) is a novel marker to detect subclinical embryo nic loss in infertile women. METHOD: In the present study EPF was used as a marker to detect subclinical embryonic loss in women treated wit h CC with/without gonadotropins. In some of the women treated with CC, conception was assisted by artificial insemination with husband's sem en (AIH). RESULTS: Our results have indicated that fertilization occur red (EPF + ve) in 47.7% (52/ 109) of women treated with CC with/withou t gonadotropins; 13.46% (7/52) retained the fetus and continued pregna ncy till full term, whereas 78.9% (41/52) did not retain the fetuses. In the group where after stimulation, conception was assisted by AIH, fertilization was observed in 38.24% (26/68), retention in 11.54% (3/2 6) but subclinical embryonic loss was observed in 80.8% (21/26) cases. CONCLUSION: Thus, our results have indicated that subclinical embryon ic loss may account for some of the discrepancy observed between the a pparently normal ovulation and the pregnancy rates in women treated wi th clomiphene citrate.