Serum CA 125 levels in early pregnancy and subsequent spontaneous abortion

Article Abstract:

Ca 125 is a cancer antigen, a protein found in the blood, body fluids and some body tissues that is capable of inducing the production of specific antibodies. High concentrations of CA 125 have been measured in the fluid surrounding the fetus (amniotic fluid), and the decidua and chorion, layers of the membrane surrounding the fetus. At the same time, high concentrations of CA 125 do not occur in the blood of either the mother or the fetus. The amount of CA 125 in the mother's blood early in pregnancy decreases to prepregnant levels after the third month of pregnancy. How CA 125 gains access to the maternal blood is not well understood. It is proposed that it does so when the epithelial basement membrane of the fetal membrane or decidua layer becomes disturbed. To see if abnormally high CA 125 is predictive of spontaneous abortion early in pregnancy, 101 pregnant women were studied. CA 125 levels were measured 18-22 days after conception and again six weeks after conception, when most pregnancy losses occur. Levels in those who aborted were compared with those in the women maintaining their pregnancies. Of the nine women with CA 125 levels greater than 150 units per milliliter (normal is 85 units per milliliter), five (55.5 percent) aborted. Four of the 92 women (4.3 percent) with levels less than 150 unit per ml aborted. Although there was a significant correlation between high CA 125 and spontaneous abortion, four of the five losses did not occur until late in the first three months or early into the second three months, after the fetus was determined to be viable. Only one out the 11 women who conceived using in vitro fertilization techniques (embryo transfer) to achieve pregnancy aborted when the CA 125 level was above 150 units per milliliter. The patient with the highest CA 125 level ever recorded, 2,180 U/ml, was measured 15 days after four embryos were transferred. Although fetal viability was established at five weeks, fetal loss was occurred at seven weeks. Chromosomal analysis of the fetal tissues revealed an abnormality. It is concluded that after fetal viability has been established in the seventh or eighth week of pregnancy, a high CA 125 may indicate an impending miscarriage. In these cases, a repeat fetal ultrasonographic image should be obtained. However, most patients do not known they are pregnant by the seventh and eighth week of pregnancy. The usefulness of such a test may be limited to infertile couples who are under pregnancy surveillance during this early conception period. (Consumer Summary produced by Reliance Medical Information, Inc.)

Miscarriage

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Ovulation and successful pregnancy in a woman with ovarian failure after hypophysectomy and gonadotropin therapy

Article Abstract:

Ovulation is induced when hormones released from the pituitary gland, gonadotropins, act on the ovaries to produce estrogen. A negative feedback system controls the hormone release by the pituitary gland. The production of gonadotropins can be suppressed with either high doses of estrogen or drugs that mimic naturally produced gonadotropin-releasing hormone. If suppression is followed by gonadotropins retrieved from menopausal women (menopausal gonadotropins), ovulation can result. A 35-year-old infertile woman was unable to ovulate because a tumor on her pituitary gland caused inadequate or ineffective gonadotropin hormones to induce ovulation. Her pituitary gland was removed and she was given menopausal gonadotropin hormone to stimulate estrogen production. The patient ovulated in six out of nine cycles. The patient became pregnant twice but lost both pregnancies within five weeks after conception. A third conception was supplemented with progesterone hormones. A healthy infant was delivered after 31 weeks of pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Analysis, Case studies, Surgery, Drug therapy, Gonadotropin, Gonadotropins, Infertility, Female, Female infertility, Pituitary gland, Ovulation

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Very high CA 125 levels during early first trimester in three cases of spontaneous abortion with chromosomal abnormalities

Article Abstract:

CA 125, an antigenic or tumor marker measurable in the blood, is increased during some disease processes. The normal level of CA 125 is less than 65 units per milliliter. During the first three months of pregnancy, this can increase to 85 units per milliliter. CA 125 was measured in three women 18 to 23 days after conception. The fetuses of all three women were alive at nine weeks of pregnancy. Two fetuses appeared small for gestational age when evaluated by fetal ultrasonography, the use of high frequency sound to visualize internal structures. All three infants subsequently died by the end of three months. Three different chromosomal abnormalities were detected at autopsy. All three fetuses were conceived with the help of ovulation-inducing drugs. It is not certain, however, that the drugs affected the CA 125, since an earlier study on the effect of artificial fertilization on CA 125 revealed no correlation. Future studies investigating the use of CA 125 in predicting abnormal chromosomes are warranted. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Genetic markers, Chromosome abnormalities, Fetal death

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