Ovulation-inducing drugs versus specific mucus therapy for cervical factor

Ovulation disorder as a possible cause of a cervical factor problem was evaluated in 30 patients with poor postcoital tests. The diagnosis of an ovulatory defect was based on follicular maturation studies included in serial pelvic ultrasonography and serial assays of serum estradiol and progesterone. Patients were divided into three groups with cervical factor presumably due to (1) immature follicular development, (2) premature luteinization, and (3) pure cervical factor. A higher pregnancy rate was achieved in the group with pure cervical factor when the therapy was directed exclusively toward improving the cervical mucus. However, a significant improvement in pregnancy rate was observed when therapy was aimed at correcting both abnormal follicular maturation and the cervical mucus problem. Combined use of pelvic sonography and quantitation of serum estradiol and progesterone allow the clinician to select the treatment for cervical factor that is most likely to achieve successful pregnancy.