ETIOLOGY OF SERUM CA-125 IN PATIENTS WITH ENDOMETRIOSIS TREATED WITH A GONADOTROPIN-RELEASING-HORMONE AGONIST (BUSERELIN)

Fifty-six patients with pelvic endometriosis were treated with a buser elin dosage of 200 mu g/day s.c. for 6 months. Scoring of the American Fertility Society (AFS) for endometriosis was performed by laparoscop y in all cases before and at the end of therapy. Serum CA-125 and estr adiol levels were determined before the treatment, and monthly during therapy and follow-up (6 months; respectively). A slight positive corr elation was found between serum CA-125 concentrations before treatment and AFS scores for adhesions only. Before treatment, serum CA-125 val ues also correlated slightly with total AFS scores of patients with ad hesions. At the end of the 6-month therapy, no correlation was found b etween CA-125 concentrations and second-look AFS scores for implants a nd/or adhesions. Serum CA-125 and estradiol values were closely parall el to each other during and after therapy with the gonadotrophin-relea sing hormone agonist buserelin. In conclusion, (1) adhesions may play a role in the elevation of serum CA-125 levels in endometriosis, and ( 2) a significant decrease in serum CA-125 values during the buserelin therapy may result from a rather different mechanism, such as ovarian suppression, other than the therapeutic effect of this agent.