Diagnosis and treatment of the cervical factor. I. Improvement with a short-course treatment of high-dose estrogen.


A new technique for improving cervical factor is described. This technique employs the use of high-dose estrogen at the time that a mature follicle is determined by ultrasound in patients who have inadequate postcoital tests despite the use of low-dose estrogen, guaifenesin, and tetracycline. Previously, a technique based on high-dose estrogen early in the follicular phase was employed; this suppressed pituitary gonadotropins, thus requiring the concomitant use of hMG. Seventy-three percent of the patients for whom this more expensive and intricate technique would have been necessary were able to achieve a good postcoital test through this modified technique of merely using high-dose estrogen when the follicle has already matured. Thirty-three percent achieved a pregnancy within 6 months on this therapy.


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