Infertility due only to the cervical factor: management and long-term prognosis

Fifty-five couples with infertility related only to the cervical factor, defined by the use of a new postcoital test scoring system (PCT), were followed prospectively until conception occurred, or 5 years had passed, on were lost for follow-up. Twenty-eight of the female partners were treated with D&C only and had a conception rate of 47% after 6 months and 64% after 5 years from registration. This rate is significantly higher (P = 0.004) when compared to a group of patients treated only with diethylstilbestrol (3) for the same length of time (1 year). In addition, a group of nine patients treated with D&C Premarin had a 78% conception rate. This was higher than the group treated only with D&C; however, statistical significance was not achieved. The study suggests that D&C has a beneficial effect on the prognosis of the couple with infertility due only to the cervical factor and also confirms that the use of the PCT scores after therapy either divided into their components, sperm and mucus, or combined as one score is not a helpful indicator for the prognosis of these couples. Finally, the hypothesized beneficial action of the D&C on endocervical and uterine environment is presented and discussed.