The treatment of cervical factor with ethinyl estradiol and human menopausal gonadotropins

Abstract

Previously we have demonstrated that one can significantly improve the cervical factor in cases that have failed with conventional therapy by employing high doses of estrogen to stimulate the cervical mucus glands. The patients are concomitantly treated with human menopausal gonadotropins to stimulate ovulation, because of endogenous gonadotropin suppression by the estrogen. Monitoring of the hMG is accomplished by pelvic sonography. Unfortunately, the serum estradiol assay cannot also be used because it would measure not only endogenous estradiol but also exogenous estradiol from the conjugated estrogens employed. A modification of this technique is described wherein the estrogen now used is ethinyl estradiol. This estrogen has very little cross-reactivity in the 17-beta-estradiol assay. Thus, both ultrasound and serum estradiol monitoring can be used, resulting in a safer and more effective technique.