Soto-Albors C, Daly D C, Ying Y K
University of Connecticut Health Center, Farmington.
Fertil Steril. 1989 Jan;51(1):58-62. doi: 10.1016/s0015-0282(16)60428-4.
Traditional therapies for abnormal cervical mucus, other than timed intrauterine insemination, are noteworthy for being ineffectual. Patients (n = 27) with documented abnormal Insler scores in repetitive cycles and failure to conceive with traditional treatments were screened with conjugated equine estrogens (CEE) for estrogen responsiveness of the cervix. Only 5 patients were found unresponsive. Seventeen patients with CEE-responsive cervices then were treated with human gonadotropins (hMG), initially 1 ampule days 5 to 11. If the mucus failed to improve, the hMG was increased to standard doses. Eight patients responded to 1 ampule hMG with improved mucus and conception. The remainder required 2 ampules hMG. In patient cycles with corrected cervical mucus, the viable fecundibility (fv) was 0.35. This is significantly higher than predicted for this population (fv = 0.09; P less than 0.01). In all, 14 of 17 patients conceived viable pregnancies during hMG treatment. It is concluded that graduated hMG is efficacious in treating patients with abnormal cervical mucus responsive to CEE. It is preferable to either in vitro fertilization or gamete intrafallopian transfer, based on both cost and efficacy for most patients.
除定时宫内授精外，治疗宫颈黏液异常的传统疗法效果不佳。对27例在多个周期中Insler评分异常且传统治疗未能受孕的患者，使用结合马雌激素（CEE）筛查宫颈的雌激素反应性。仅发现5例患者无反应。然后，对17例宫颈对CEE有反应的患者使用人促性腺激素（hMG）进行治疗，最初在第5至11天每天1安瓿。如果黏液没有改善，hMG剂量增加至标准剂量。8例患者对每天1安瓿hMG有反应，黏液改善并受孕。其余患者需要每天2安瓿hMG。在宫颈黏液得到改善的患者周期中，可行生育力（fv）为0.35。这显著高于该人群的预测值（fv = 0.09；P<0.01）。总之，17例患者中有14例在hMG治疗期间成功受孕。结论是，递增剂量的hMG对治疗宫颈黏液异常且对CEE有反应的患者有效。基于成本和对大多数患者的疗效，它优于体外受精或配子输卵管内移植。
