De. Pittaway et al., CLINICAL-EVALUATION OF CA-125 CONCENTRATIONS AS A PROGNOSTIC FACTOR FOR PREGNANCY IN INFERTILE WOMEN WITH SURGICALLY TREATED ENDOMETRIOSIS, Fertility and sterility, 64(2), 1995, pp. 321-324
Objective: To extend and confirm earlier observations that serial CA-1
25 determinations appear to have prognostic value in some infertile wo
men with surgically treated endometriosis using a new automated enzyme
immunoassay. Design: A prospective consecutive case series. Setting:
A university-based tertiary practice. Patients: Of 342 women having a
laparoscopy for infertility, 123 (36%) had endometriosis. Fifty-six of
123 (45%) infertile women with endometriosis had preoperative CA-125
values greater than or equal to 16 U/mL and were followed for 12 month
s with serial CA-125 determinations. Main Outcome Measure: Proportion
of women achieving a pregnancy within 12 months from surgery. Results:
Mean preoperative CA-125 concentrations were not statistically differ
ent for women conceiving, but mean postoperative CA-125 values were si
gnificantly lower for women achieving a pregnancy. Univariate analyses
indicated that preoperative CA-125 values between 16-25 U/mL and post
operative CA-125 values < 16 U/mL were associated with significantly h
igher pregnancy rates. Multivariate analyses of 10 covariables indicat
ed only postoperative CA-125 concentrations to be associated with preg
nancy even after controlling for all covariables. Conclusion: Using a
newly developed assay for CA-125, the study confirms and extends earli
er observation that CA-125 concentrations have prognostic value for pr
egnancy in infertile women with surgically treated endometriosis. The
findings provide additional support for the clinical use of CA-125 con
centrations in selected women with endometriosis.