Application Of Serum CA125 In Controlled Ovarian Hyperstimulation Technique

Objective:Adopt a series of studies which contain a retrospective case control study and a prospective cohort study to explore whether antigen CA125 can be an assist biomarker for the accomplishment of down regulation and to explore the value of CA125 in prognosis patients' pregnancy after embryo transplantation.Method: Retrospective analysis all the patients(inclusion 164 patients)who use prolonged protocol cycle to controlled ovarian hyperstimulation in our hospital from June 2015 to June2016.The patients are divide into two groups,pregnancy group(110 patients)and unpregnancy group(54 patients),compare the CA125 level of two groups after down regulation.Then through statistical method and combine clinic practical to find out the factor that related to patients' pregnancy after embryo transplantation and each factor's correlation level.(2)Adopt prospective study,incorporate 100 patients who use prolonged protocol cycle to controlled ovarian hyperstimulation in our hospital from July 2016 to January 2017.On the basis of retrospective analysis,according to CA125 level after down regulation divide into case group(64 patients,CA125 level after down regulation less than10.5U/ml)and control group(36 patients,CA125 level after down regulation more than10.5U/ml)).Record and compare two group in fundamental date,medicine for controlled ovarian hyperstimulation,oocytes,embryo and clinical outcome and other aspects.Result: The result of retrospective study:(1)There is no statistically significant differences between two groups in age,BMI,AFC,basal FSH,basal E2,basal FSH/LH,GnRH-a doses,time of stimulate ovulation,E2/Target follicles and P/Target follicles on the day of HCG,rate of embryo at metaphase II,rate of 2PN,endometrial thickness on the day of embryo transfer and the score of embryo transplanted.(2)There is statistically significant differences between two groups in basal LH,CA125 level after down regulation and doses of drug for promote.(3)Factors which may affect pregnancy to analysis by Logistic regression equation show that pregnancy have negative correlation with CA125 level after down regulation and basal FSH/LH.OR(basal FSH/LH)=0.662,OR(CA125 level after down regulation)=0.904(4)Make receiver operating characteristic curve by pregnancy and CA125 level after down regulation show that the area underROC is 0.749,cutoff value is 10.5U/ml.The result of prospective study:(1)There is no statistically significant differences between case group and control group in some in fundamental date such as age,height,weight,BMI,infertility duration,type of infertility,AFC,AMH,bFSH,bFSH/b LH,bE2,PRL,TSH,the level of CA125 in natural cycles and the level of CRP in natural cycles.There is no statistically significant differences between two group in ovulation induction aspect such as E2 and LH level after down regulation,total doses of GnRH-a,total doses of Gn,every day dose of Gn,number of follicle and level of progestin on the day of HCG injection.There is no statistically significant differences between two group in husband sperm for example: the density and activity of the sperm,sperm morphology,DFI,HDS.There is no statistically significant differences between two group in number of ovum pick-up,the way of fertilization,follicle out put rate,the number of MII,2PN,2PN rate,high-quality embryo,transfered-embryo score,and endometrial thickness on transfer day.There is no statistically significant differences between case group and control group in certain clinical outcome,such as the rate of ectopic pregnancy or multiple pregnancy,HCG,E2,P,CA125 level on the day to urine test.(2)There is statistically significant differences between case group and control group in basal LH,depression ratio of CA125,CA125 level after down regulation,CRP level after down regulation,time for Gn,MII rate,merogenesis rate,high-quality embryo rate,implantation rate and pregnancy rate.Compare to control group,case group have higher MII rate,merogenesis rate,high-quality embryo rate,implantation rate and pregnancy rate.Conclusion:(1)CA125 level after down regulation have negative correlation with the pregnancy after embryo transplantation.(2)CA125 can be the assist biomaker for the accomplishment of down regulation in controlled ovarian hyperstimulation.(3)When the CA125 level after down regulation less than 10.5U/ml,patients can have better MII rate,merogenesis rate,high-quality embryo rate,implantation rate and pregnancy rate.(4)There are certain value of CA125 in prognosis patients' pregnancy after embryo transplantation.