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Vol. 54, No.3, September 1990

FERTILITY AND STERILITY

Printed on acid-free paper in U.S.A.

Copyright" 1990 The American Fertility Society

Serum CA-125 levels do not depend on ovarian steroidogenesis

Antonio Lanzone, M.D. Anna Maria Fulghesu, M.D. Costabile Guida, M.D.

Roberto Muscatello, M.D. Alessandro Caruso, M.D. Salvatore Mancuso, M.D.*

Department of Obstetrics and Gynecology, Universita Cattolica del Sacro Cuore, Rome, Italy

To investigate the relationship between CA-125 production and ovarian steroidogenesis, serum CA -125 levels were evaluated in patients with normal pelvis in different ovarian endocrine situations: (1) during the menstrual cycle, (2) during stimulatory treatment with gonadotropin for the induction of ovulation, and (3) during suppression treatment with gonadotropin-releasing hormone agonists. In spite of the spontaneous or the markedly induced variations of estradiol (E 2 ) or ovarian volume, CA-125 levels remained unvaried in all patients. Moreover, CA-125 serum levels did not correlate with the increasing values of the plasma E2 or ovarian volume. In conclusion, steroidogenetic activity of the ovary is unlikely to affect CA-125 production. Fertil Steril54:415, 1990

Elevated CA-125 serum levels have been associated with a number of gynecologic and nongynecologic malignancies but primarily with ovarian carcinoma. 1,2 Moreover, slightly elevated CA-125 concentrations have been observed in benign conditions such as endometriosis and pelvic inflammatory disease. 2,3 Pregnancy has also been observed to induce a slight increase in levels of this substance. 4 Some authors have suggested that CA-125 is a cell surface antigen expressed in some derivatives of celomatic epitheliumS but generally not expressed in the theca-stromal or granulosa-ovarian cell compartments. There are conflicting reports about the variation of CA-125 during a spontaneous menstrual cycle.6 - 8 Recently, some authors reported that CA-125 may modify serum concentrations in a manner related to endocrine ovarian steroidogenesis. 9 - 11 This study was designed to

Received February 2, 1990; revised and accepted May 3, 1990.

* Reprint requests: Salvatore Mancuso, M.D., Department of Obstetrics and Gynecology, Universita Cattolica Sacro Cuore, Largo Gemelli 8, 00168 Rome, Italy.

Vol. 54, No.3, September 1990

investigate the changes of CA-125 levels in different states of ovarian steroidogenetic activity. MATERIALS AND METHODS

Three groups of patients were retrospectively examined. Group I consisted of six consecutive women (ages 25 to 37 years) with normal pelvis at laparoscopic examination, performed for unexplained infertility. In these patients, spontaneous follicular growth and ovulation were monitored by ultrasound (US). Serum samples were collected daily starting from day 5 after menses until ovulation, and at early luteal, (day +2 from ovulation), midluteal (day +7 from ovulation), and late luteal phase (day +11 from ovulation). Groups II and III consisted of patients treated with different gonadotropin (Gn) regimens to induce ovulation. All cycles were ovulatory and none of these cycles were conceptive. In group II, there were eight women (ages 22 to 34 years) with unexplained or male factor infertility with normal pelvis in whom ovulation was induced by Gns for eight cycles (four normostimulated; four hyperstimulated). Starting on day 5

Lanzone et al.

CA -125 and ovarian steroidogenesis

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after spontaneous menses, pure follicle-stimulating hormone (FSH, Metrodin; Serono, Rome, Italy, 75 IU FSH, and

Serum CA-125 levels do not depend on ovarian steroidogenesis.

To investigate the relationship between CA-125 production and ovarian steroidogenesis, serum CA-125 levels were evaluated in patients with normal pelv...
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