CLINICAL-EVALUATION OF CA-125 CONCENTRATIONS AS A PROGNOSTIC FACTOR FOR PREGNANCY IN INFERTILE WOMEN WITH SURGICALLY TREATED ENDOMETRIOSIS

Objective: To extend and confirm earlier observations that serial CA-125 determinations appear to have prognostic value in some infertile women 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 months 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 different for women conceiving, but mean postoperative CA-125 values were significantly lower for women achieving a pregnancy. Univariate analyses indicated that preoperative CA-125 values between 16-25 U/mL and postoperative CA-125 values < 16 U/mL were associated with significantly higher pregnancy rates. Multivariate analyses of 10 covariables indicated only postoperative CA-125 concentrations to be associated with pregnancy even after controlling for all covariables. Conclusion: Using a newly developed assay for CA-125, the study confirms and extends earlier observation that CA-125 concentrations have prognostic value for pregnancy in infertile women with surgically treated endometriosis. The findings provide additional support for the clinical use of CA-125 concentrations in selected women with endometriosis.