RESUMO
OBJECTIVE: To assess the relationship between the concentrations of total immunoreactive alpha-inhibin in human seminal plasma, sperm quality, and in vitro fertilization (IVF) rates. SETTING: Medical school hospital. DESIGN: Prospective study. PATIENTS: 72 consecutive couples undergoing IVF with husband's sperm in which at least 4 oocytes were obtained. MAIN OUTCOME MEASURES: Alpha-inhibin determination by means of enzyme-linked immunosorbent assay, sperm analysis for density and motility, IVF rates. RESULTS: Total immunoreactive alpha-inhibin levels were not correlated with IVF rates. Nor were there any differences in fertilization rates in the different groups. Lower inhibin levels were found in oligozoospermic cases. Lower sperm counts were found in cases with inhibin values below the median value, and also with respect to various other cutoffs. No correlation was found between inhibin levels and any of the sperm variables measured. CONCLUSION: Total immunoreactive alpha-inhibin is not a prognostic factor in IVF cycles. However, an association was found between inhibin and sperm concentration, suggesting that alpha-inhibin in the human seminal fluid could be a marker for some aspects of spermatogenesis.
Assuntos
Fertilização in vitro/estatística & dados numéricos , Inibinas/análise , Sêmen/química , Espermatozoides/citologia , Adulto , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Inibinas/imunologia , Masculino , Pessoa de Meia-Idade , Gravidez/estatística & dados numéricos , Prognóstico , Estudos Prospectivos , Contagem de Espermatozoides , Motilidade dos Espermatozoides , Estatísticas não ParamétricasRESUMO
OBJECTIVE: To assess the relationship between carbohydrate tumor markers in seminal plasma and fertilization rates in IVF cycles. DESIGN: Prospective study. SETTING: Academic tertiary hospital. PATIENTS: Forty-six consecutive couples subjected to IVF in which at least one oocyte was obtained. MAIN OUTCOME MEASURES: Determination of CA-19.9, CA-125, and CA-195 in seminal plasma 1 week before IVF. RESULTS: CA-125 was higher in the group without fertilization (321 +/- 198 U/mL, mean +/- SD) than in the group in which at least one oocyte was fertilized (155 +/- 165 U/mL), whereas CA-19.9 and CA-195 were similar in both groups. However, at the cutoff 66%, lower values of CA-19.9 were found in the fertilization group rate < 66% (707 +/- 1,217 versus 1,069 +/- 1,084) and of CA-195 (67 +/- 44 versus 218 +/- 274). No correlation was found between tumor marker levels and fertilization rates. CONCLUSION: CA-125 seems to be an indicator of sperm fertilization capacity, whereas the importance of CA-195 and CA-19.9 will require further studies.
Assuntos
Antígenos Glicosídicos Associados a Tumores/análise , Antígeno Ca-125/análise , Antígeno CA-19-9/análise , Fertilização in vitro , Gravidez , Sêmen/química , Biomarcadores/análise , Feminino , Humanos , Masculino , Estudos Prospectivos , Valores de ReferênciaRESUMO
OBJECTIVE: To evaluate tumor markers in seminal plasma and their possible relationship with fertility. METHODS: Five different tumor markers (alpha-fetoprotein, CA 125, CA 19.9, CA 50, and CA195) were studied in seminal plasma and serum from 42 males (14 volunteers from semen donation and 28 males from infertile couples). RESULTS: CA 50 and CA 19.9 levels were more than 300 times as high in seminal plasma as in serum (4,396.4 U/mL vs. 13.9 and 3,893.5 U/mL vs. 11.5). CA 125 levels were 14 times as high in seminal fluid as in serum (217.2 U/mL vs. 15.1), and CA 195 levels 22 times as high (122.5 U/mL vs. 5.6). alpha-Fetoprotein levels in seminal plasma were one-third those in serum (0.75 ng/mL vs. 2.47). Seminal levels of CA 125, CA 50, and CA 19.9 were correlated with the duration of infertility. Compared with donors, among seminal fluids from infertile couples there was a trend to higher levels of CA 19.9 and CA 125. CA 125 levels were lower in samples having normal sperm counts, and CA 125 and CA 19.9 levels were lower among couples who conceived compared with those who did not conceive. Tumor markers, either in seminal plasma or in serum, were not found to be correlated with semen characteristics. CONCLUSIONS: It appears that seminal levels of the tumor markers studied depend on more factors than the single serum concentration. The biological significance of the high seminal levels of the four carbohydrate antigens, and the association of low levels of CA 125 and CA 19.9 and fertility, could not be determined from our study. It is suggested, however, that CA 125 and CA 19.9 could be used as seminal plasma markers of fertility.
