Clinical Usefulness of Early Pregnancy Factor in Women with Threatened Abortion, Normal PregnantWomen and in Vitro Fertilization-Embryo Transfer Patients / 대한산부인과학회잡지

ABSTRACT

Early pregnancy factor(EPF) is believed to be a pregnancy-associated immunosuppressivepolypeptide which might inhibit the function of maternal lymphocyte during pregnancy. Thephysiological role of EPF in human pregnancy has remained controversal. The purposes of thisstudy are to investigate whether EPF determinations have prognostic value in women withthreatened abortion, and to evaluate usefulness in diagnosing early pregnancy and in predictingthe outcome of embryo transferred in vitro fertilization-embryo transfer(IVF-ET) program.EPF activity was measured by a recently developed, micro rosette inhibition test in sera from76 normal pregnant women, 25 normal healthy women with tubal ligation, 58 women withtherapeutic surgical abortion(n=18) or threatened abortion(n=40) and 29 IVF-ET patients. Rosetteinhibition titer>or=3 was defined as an index for the presence of EPF activity. EPF activity wasundetectable in sera of normal healthy women with tubal ligation and in sera taken before ET.In normal pregnancy EPF was detected in 88~92% of sera during the first and second trimesterand almost disappeared in the third trimester. Surgical therapeutic abortion in the firsttrimester lead to disappearance of EPF activity in 92.3% of cases second day after procedure.The sensitivity of the EPF assay in predicting the outcome in pregnant women with threatenedabortion was 88.0% and the specificity was found to be 86.7%. In patients who became pregnantafter IVF-ET procedure EPF activity was detected in 85.7% of sera on the 5th day andin all sera on the 12th day. In 80.0%(9/13) sera of patients who failed to become pregnant afterET, EPT activity was detected on the 5th day but 17(94.4%) of 18 sera was proved to benegative for EPF activity on the 12th day. These data suggest that EPF assay by micro rosetteinhibition test may be useful in monitoring the embryo after ET, in dignosing early pregnancyand in predicting the outcome in women with threatened abortion.