Effect of an in vitro fertilization program on serum CA 125, tumor-associated trypsin inhibitor, free beta-subunit of human chorionic gonadotropin, and common alpha-subunit of glycoprotein hormones

Objective: To investigate the impact of an IVF program on serum levels of t umor markers CA 125, tumor-associated trypsin inhibitor, free hCG beta -sub unit, and free glycoprotein hormone alpha -subunit. Design: A prospective controlled clinical study. Setting: Outpatient university infertility clinic. Patient(s): Seventy-one infertile patients (with tubal occlusion, pelvic en dometriosis, or unexplained infertility) undergoing IVF and nine control wo men with regular menstrual cycles. Intervention(s): Serial blood sampling before, during, and after IVF, or du ring one ovulatory menstrual cycle in the controls. Main Outcome Measure(s): Serum levels of CA 125, tumor-associated trypsin i nhibitor, hCG-beta, and glycoprotein hormone-alpha. Result(s): Before IVF, all tumor markers were within the normal range excep t for CA 125, which was elevated in patients with endometriosis. IVF led to significant increases in CA 125 and glycoprotein hormone-alpha that differ ed from the changes seen during normal menstrual cycles. The luteal phase i ncrease in CA 125 correlated with levels of E-2 and P and the number of fol licles. Two months after IVF, levels of CA 125 were 12% higher than levels before treatment. Tumor-associated trypsin inhibitor and hCG-beta revealed no cyclicity. Conclusion(s): An IVF regimen increased the release of CA 125 and glycoprot ein hormone-alpha. The CA 125 elevation after IVF implies a persistent effe ct of ovarian hyperstimulation on CA 125 release. (Fertil Steril(R) 2000;74 :1125-32. (C) 2000 by American Society for Reproductive Medicine).