High Doses of Cyclophenil Versus Hmg Therapy in Clomiphene Citrate Resistant Patients.

A model using multiple variables including CA 125 concentrations has been developed to estimate the probability of pregnancy in selected women with endometriosis associated infertility.The woman's age, presence or absence of pain, the preoperative CA 125 concentration, and the difference between the preoperative and postoperative CA 125 concentrations were selected as the variables in the model as established by previous multivariate analyses.Objective: To test the model in a prospective trial.Design: Prospective clinical trial.Materials and Methods: Sixty consecutive infertile women with elevated (---24 U/mL) preoperative CA 125 concentrations were followed for 12 months after surgical treatment of their endometriosis.The women were assigned according to the model's predicted probability of pregnancy to one of four groups with (I) ->56%; (II) 26-55%, (III) 11-25% and (IV) -<10%.Concentrations of CA 125 were determined by an immunoradiometric assay (CA 125 II Centocor, Malvern, PA).Results: No differences in age, stage of endometriosis, duration of infertility, gravidity, and previous treatments were observed among the groups.Twenty-five pregnancies (42%) occurred with three resulting in spontaneous abortion (12%).The clinical pregnancy rates for Groups I, II, III and IV were 78%, 54%, 23% and 8%, respectively.Cycle fecundities for the four groups were 0.111, 0.062, 0.022 and 0.007, respectively.Conclusions: The probability of pregnancy was correctly predicted by the model.The model identifies subgroups of infertile women with very high and very low probabilities of pregnancy.The use of the model may assist the clinician in selecting appropriate management options after the surgical treatment of endometriosis, such as expectant management or assisted reproductive techniques.