Clinical Significance of CA-125 and Insulin-like Growth Factor Binding Protein-3 ( IGFBP-3 ) as a Prognostic Factor for Pregnancy Outcome in In Vitro Fertilization and Embryo Transfer

Mok, J E; Chang, Y S; Kang, B M; Kim, J H; Chae, H D; Jeon, D J; Kang, E H

Abstract

It is well known that the outcome of IVF-ET and controlled ovulation hyperstimulation (COH) is strongly dependent on ovarian responsiveness to exogeneous stimulation. The growth factors or cytokines seem to play an important role in ovarian responsiveness. Recently, among these cytokines, growth hormone (GH)/insulin-like growth factors (IGFs) or its binding proteins (IGFBPs) axis activity have been reported to be a good marker of ovarian autocrine/paracrine activity. In view of this, we performed this study to determine if the serum concentrations of CA-125 and IGFBP-3 are relavant to the pregnancy outcome in patients undergoing IVF-ET. From March 1997 to July 1997, the serum concentrations of CA-125 and IGFBP-3 were evaluated prospectively in 44 patients undergoing IVF-ET on the day of hCG administration, oocyte retrieval, and ET, respectively. The patients were grouped into pregnant (n=12) and non-pregnant (n=32). There were no differences between the two groups in the serum CA-125 concentrations on the day of hCG administration, oocyte retrieval, and ET. There were also no differences between the two groups in the serum IGFBP-3 concentrations on the day of hCG administration and oocyte retrieval. However, the serum IGFBP-3 concentration on the day of ET in the pregnant group was significantly higher than that of the non-pregnant group (p<0.05). In addition, the serum IGFBP-3 concentration decreased significantly in the non-pregnant cycles from hCG day to ET day and from oocyte retrieval day to ET day compared with the pregnant group (p<0.05), whereas the serum CA-125 concentration showed no significant change in both groups. In conclusion, the serum IGFBP-3 concentration on the day of ET and the changes of serum IGFBP-3 concentrations from hCG day to ET day might be predictive of the subsequent pregnancy of the patients undergoing IVF-ET and also could contribute to effective management of infertile couples.