EVALUATION OF SERUM CA-125 CONCENTRATIONS AS PREDICTORS OF PREGNANCY WITH HUMAN IN-VITRO FERTILIZATION

Objective: To determine if CA 125, a product of human endometrium, may be an indicator of early endometrial function. To test this hypothesi s we examined CA 125 concentrations before oocyte retrieval in IVF cyc les. Design: Retrospective data analysis of 111 consecutive IVF cycles . Setting: Tertiary care academic medical center. Patients: All women who received luteal leuprolide acetate (LA) suppression followed by hM G for IVF and had sera available for analyses were entered into the st udy. Main Outcome Measure: Serum CA 125 was measured in the previous l uteal cycle, day 7 of hMG, day before, and day of hCG administration. Twelve other variables were analyzed. Results: Fifty-six cycles (47 wo men) qualified for evaluation and included 25 pregnant cycles (45%) an d 31 nonpregnant cycles. Higher serum CA 125 concentrations were assoc iated with pregnancy in both endometriosis and nonendometriosis subgro ups. CA 125 values on the day of hCG administration were the best pred ictors of pregnancy, with levels greater than or equal to 16 U/mL havi ng a sensitivity of 72%, specificity of 97%, and a positive predictive value of 95% for pregnancy. The other variables were not predictive o f pregnancy. Conclusions: With a LA and hMG stimulation protocol, incr eased CA 125 concentrations before retrieval are associated with very high pregnancy rates. The source(s) of the serum CA 125, although as y et undetermined, may be of endometrial origin. The study supports furt her evaluation of CA 125 concentrations in IVF as a preretrieval predi ctor of pregnancy.