Elstein M, Fawcett G M
Ciba Found Symp. 1984;109:173-9. doi: 10.1002/9780470720905.ch12.
The anti-oestrogens clomiphene and tamoxifen are successful therapeutic agents in the induction of ovulation but the associated pregnancy rates are low. One cause for this may be a direct anti-oestrogenic effect on cervical mucus, reducing its sperm penetrability. This potentially adverse effect has been shown to occur with clomiphene. In this study the effects of clomiphene and tamoxifen on the cervical factor are compared in women who were anovulatory or had defective ovulation. Forty fully investigated infertile women were randomly allocated to different treatment sequences after being observed for three control cycles. A double-blind placebo technique was used with four different treatment regimes. Serial serum progesterone and oestradiol were assayed. Cervical mucus from the periovulatory phase was assessed by means of the cervical score and in vitro sperm penetration tests. Both these anti-oestrogens can affect cervical mucus but their effect seems to be related more to the end-organ sensitivity of the individual than to a specific action of the drug per se.
抗雌激素药物克罗米芬和他莫昔芬是诱导排卵的成功治疗药物，但相关的妊娠率较低。造成这种情况的一个原因可能是其对宫颈黏液有直接的抗雌激素作用，降低了其精子穿透性。已证明克罗米芬会出现这种潜在的不良反应。在本研究中，对无排卵或排卵功能缺陷的女性比较了克罗米芬和他莫昔芬对宫颈因素的影响。40名经过全面检查的不孕女性在经过三个对照周期观察后，被随机分配到不同的治疗序列。采用双盲安慰剂技术，有四种不同的治疗方案。测定了血清孕酮和雌二醇的系列值。通过宫颈评分和体外精子穿透试验对排卵期前后的宫颈黏液进行评估。这两种抗雌激素药物均可影响宫颈黏液，但它们的作用似乎更多地与个体的终末器官敏感性有关，而非药物本身的特定作用。
