子宫内膜异位症血清CA125水平与体外受精结局

The Relationship Between the Serum CA125 Level and the Outcomes of In Vitro Fertilization in Endometriosis

目的:探讨子宫内膜异位症(EMs)不孕患者体外受精-胚胎移植(IVF-ET)前血清CA125水平与其结局的关系。方法:在控制性超排卵前一周期的非月经期测定65例(67个周期)中-重度EMs不孕(EMs组)及78例(78个周期)输卵管不孕(对照组)患者的血清CA125水平。对两组IVF-ET不同结局及其血清CA125水平进行分析。结果:EMs组IVF-ET不良结局发生率高于对照组(P=0.044),有不良结局的患者血清CA125水平高于对照组中相应的患者(P=0.000)。EMs组内不良结局患者血清CA125水平高于继续妊娠患者(P=0.002)。EMs组血清CA125水平与不良结局呈显著正相关(rs=0.427,P=0.002),血清CA125最佳截断点为12.37kU/L,当以CA125≥12.37kU/L为依据,判别EMs不孕患者IVF-ET不良结局的敏感性为83%(39/47),特异性为80%(16/20),准确率为82%(55/67)。结论:EMs患者IVF-ET前血清CA125≥12.37kU/L预示其结局可能不良。

Objective： To study the relationship between the serum CA125 level before IVF-ET and the outcomes of IVF-ET in infertile patients with endometriosis （EMs）. Methods： The serum CA125 levels were measured in the EMs group （65 patients, 67 cycles, with moderate-severe EMs infertility） and the control group （78 patients, 78cycles, with tubal infertility） during non-menstrual phase before controlled ovarian hyperstimulation. The outcomes of IVF-ET and the levels of serum CA125 were analyzed in the both groups. Results： The incidence of adverse outcomes of IVF-ET in the EMs group was higher than the control group （P=0.044）, and the serum CA125 levels of patients with adverse outcomes were significantly higher than the control group （P=O.000）. In the EMs group, the levels of serum CA125 with adverse outcomes were markedly higher than the continued pregnancy （P=0.002）, and there was significant positive correlation between serum CA125 level and adverse outcome of IVF-ET （r,=0.427, P=-0.002）. The optimal cut-off value of serum CA125 was 12.37 kU/L. When the serum CA125≥ 12.37 kU/L was used as a basis, the sensitivity, specificity and accuracy of the evaluation for adverse outcome of IVF-ET were 83% （39/47）, 80% （16/20） and 82% （55/67）, respectively. Conclusions： The serum CA125 ≥ 12.37 kU/L before IVF-ET predicts the possible adverse outcome for the infertile patients with EMs.