Maturation value as an indicator of the serum estrogen concentration during treatment with gonadotropins

Smears were taken each day from the middle third of the lateral vaginal wall of 14 infertile women being treated with daily intramuscular injections of human menopausal gonadotropins followed by human chorionic gonadotropins to induce ovulation. Each smear was stained with modified Papanicolaou stain and screened for the maturation index (MI), which was then converted to Meisel's maturation value (MV). In the 23 treatment cycles, the MV of the vaginal smears was compared to daily serum estrogen concentrations. In 7 of the 23 cycles the MV predicted a rise in serum estrogens; in 16, however, the MV did not predict the increasing serum estrogen concentrations. Although determination of the MV is inexpensive, easily obtained and rapidly performed, the cytologic examination of the vaginal epithelium cannot be used to predict the dynamic changes in serum estrogen concentrations during gonadotropin treatment.