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Hum. Reprod. Advance Access published online on June 2, 2007
Human Reproduction, doi:10.1093/humrep/dem130
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Highly specific and sensitive rise in Days 14–17 pro-{alpha}C inhibin with clinical pregnancy after frozen embryo transfer with ovulatory cycles

S. Tong1,4, L. Rombauts1,2, J. Onwude3, B. Marjono1 and E.M. Wallace1

1 Centre for Women's Health Research, Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash University, 246 Clayton Road, Clayton 3168, Victoria, Australia 2 Monash IVF, Clayton 3168, Victoria, Australia 3 Capio Springfield Hospital, Lawn Lane, Chelmsford CM1 7GU, UK

4 Correspondence address. Tel: +613-9594-5489; Fax: +613-9594-6389; E-mail: stephentong1{at}gmail.com

BACKGROUND: Pro-{alpha}C inhibins are luteal derived analytes peaking in the maternal serum as early as Day 16 after conception. We set out to verify a previous post hoc analysis which suggested that pro-{alpha}C levels measured this early are extremely sensitive in predicting clinical pregnancy success after unstimulated IVF with ovulatory cycles.

METHODS: Prospective observational study of 246 women undergoing frozen embryo transfer with ovulatory cycles. Serum pro-{alpha}C and beta-HCG levels at 14–17 days after conception were measured by enzyme-linked immunosorbent assay and grouped according to whether a clinical pregnancy occurred (demonstrable cardiac activity at ≥6 weeks' gestation).

RESULTS: Of 34 (13.8%) women who achieved a clinical pregnancy, median (25th–75th centile) Days 14–17 pro-{alpha}C levels were 995 pg/ml (758–1463), 6- to 7-fold higher than levels observed in the remainder who did not fall pregnant (112.8 pg/ml (104–121); P < 0.0001). At a fixed 95% specificity, pro-{alpha}C was 100% sensitive in predicting clinical pregnancy. The best specificities achieved at 100% sensitivity were; 94.8% for pro-{alpha}C, 96.7% for beta-HCG and 98.1% when both analytes were combined.

CONCLUSIONS: Clinical pregnancy is always associated with a release of luteal derived pro-{alpha}C 14–17 days after conception. Pro-{alpha}C may play a possible biological role and be a useful clinical biomarker of luteal health.

Key words: pro-{alpha}C/IVF/luteal/inhibin/frozen embryo transfer

Submitted on February 13, 2007; resubmitted on April 16, 2007; accepted on April 19, 2007.


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