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Korean Journal of Obstetrics & Gynecology 1998;41(8):2119-2125.
Published online January 1, 2001.
Influence of Serum CA-125 Level Change in Controlled Ovarian Hyperstimulation on Outcomes of In Vitro Fertilization and Embryo Transfer.
S H Kim, B H Lee, W S Seo, M H Kim, B C Jee, C S Suh, Y M Choi, J K Kim, S Y Moon, J Y Lee
Abstract
Cancer antigen 125 (CA-125) is a glycoprotein surface antigen expressed in the organs deriving from coelomic epithelium. The elevated serum levels of CA-125 can be found in patients with various malignancies including ovarian cancer, and in women with benign gynecological conditions such as endometriosis, uterine myoma, ovarian cyst, and pelvic inflammatory disease which mostly may be associated with infertility or subfertility. It is well known that the peritoneal irritation and endometrial pathology causing the elevated serum levels of CA-125 may influence on the outcome of assisted reproductive technology (ART). The objective of this retrospective clinical study was to evaluate the influence of serum CA-125 level change in controlled ovarian hyperstimulation (COH) on the outcome of in vitro fertilization and embryo transfer(IVF-ET). From January to July, 1997, 45 infertile patients undergoing COH for IVF-ET were classified into two groups: Group I -31 patients with post-stimulation vs. basal serum CA-125 level ratio <1.0, and Group II-14 patients with post-stimulation vs. basal serum CA-125 level ratio > or =1.0. The clinical characteristics of patients and the outcome of IVF-ET were statistically analyzed and compared. There were no significant differences in the age of patients, the duration, type and etiology of infertility, the number of previous IVF-ET cycles, and the basal serum FSH level between two groups. There were also no significant differences in the cancellation rate of COH, the peak serum estradiol (E2) level, the numbers of oocytes retrieved and embryos transferred, and the fertilization rate between two groups. The implantation rate per embryo and the clinical pregnancy rate (PR) per cycle and ET were 7.1%, 19.4% (6/31), and 20.7% (6/29) in Group I, and 5.6%, 28.6% (4/14), and 28.6% (4/14) in Group II, respectively, and they showed no significant differences. In addition, the ongoing PR per cycle and ET were not significantly different in two groups. In conclusion, the change of serum CA-125 level in COH does not give any predictive information on the outcome of IVF-ET, and COH for IVF-ET may have no detrimental effects on the pathophysiology of various infertility factors associated with the elevated serum levels of CA-125.
Key Words: Infertility, IVF-ET, Controlled ovarian hyperstimulation ( COH ), CA-125, Pregnancy


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