Endometrial protein PP14 and CA-125 in recurrent miscarriage patients; correlation with pregnancy outcome

Abstract

The concentrations of endometrial proteins PP14 and CA-125 were measured in uterine flushings taken on days LH+10 and LH+12 (10 and 12 days after luteinizing hormone surge) of the menstrual cycle from 15 normal, fertile women and 49 women who suffered recurrent miscarriage. The concentration of PP14 was significantly lower in the flushings from the recurrent miscarriage patients than in those from fertile controls on both day LH+10 (median: 1300, range: 3-10 300 ng/ml versus median: 13 933, range: 2174-40 404 ng/ml; P < 0.01) and LH+12 (median: 1560, range: 820-12 100 ng/ml versus median: 14 047, range 1402-62 108 ng/ml; P < 0.05). Similarly concentrations of CA-125 were significantly lower in flushings from recurrent miscarriage women compared to controls on both day LH + 10 (median: 1555, range: 47-6710 U/ml versus median: 6385.5, range 2884-27 731 U/ml, P < 0.01) and LH+12 (median: 2892, range: 956-9974 U/ml versus median: 7127.5, range: 1591-21 343 U/ml; P < 0.05). In contrast there was no significant difference in the concentration of PP14 in plasma samples taken on the same days as the flushings from recurrent miscarriage patients and fertile controls. The concentrations of PP14 in uterine flushings obtained on day LH + 10 or LH + 12 from recurrent miscarriage women during a pre-pregnancy investigative cycle were significantly lower (P < 0.05) in patients who went on to miscarry (median: 1000, range: 9-2900 ng/ml) than those who went on to have a live birth (median: 1440, range: 4-12 100 ng/ml) during a subsequent pregnancy. In contrast there was no significant difference in uterine CA-125 or plasma PP14 concentrations between these two groups of recurrent miscarriage patients. The results suggest that measurements of uterine PP14 and CA-125 may be useful in the assessment of endometrial development in recurrent miscarriage patients and suggest the importance of PP14 in preparing the endometrium for embryo implantation. In addition pre-pregnancy uterine PP14 measurements may be useful in predicting subsequent pregnancy outcome.

Glycodelin in reproductive endocrinology and hormone-related cancer

“…In such conditions, subnormal glycodelin concentrations have been reported in endometrium, uterine flushings and serum at the time of expected endometrial receptivity (82)(83)(84)(85). Both glycodelin mRNA and protein are downregulated in human first trimester miscarriage (86), and pregnant women with polycystic ovary syndrome (PCOS), who subsequently miscarry show subnormal rise of glycodelin serum concentration during the first trimester, compatible with weaker placentation (87).…”

Purification and Characterization of an Immunomodulatory Endometrial Protein, Glycodelin

“…Progesterone (15,16), relaxin (17,18), and chorionic gonadotropin (19) have been proposed as the major physiological stimuli of glycodelin synthesis and secretion by the primate endometrium. Low glycodelin concentrations were observed in secretory phase uterine flushings from women with a history of recurrent miscarriages (20). Although functional studies are limited, preliminary data indicate that glycodelin has immunosuppressive effects that are postulated to facilitate the embryonic evasion of the maternal immune response (21).…”

Dermatlas:An Online Collaborative Education Tool

“…One report demonstrated that concentration of CA-125 in the pregnant women who subsequently aborted were higher than those who did not, thus suggesting that serum CA-125 are not so important in maintaining successful pregnancy (27). CA-125 may be useful in the assessment of endometrial development in recurrent miscarriage patients and this suggested the importance in preparing the endometrium for embryo implantation (28). High level of serum CA-125 with high lactate dehydrogenase indicates more extensive trophoblastic tissue damage (29).…”