The dose-time relationship of estradiol-17β and lung cholinesterase

Abstract

those treated with clomiphene alone, while ovulation occurred in 29 (70.7 per cent) and pregnancy in 8 (21.9 per cent) in those treated with clomiphene and Quinestrol (see Table I). Twenty-eight of the 41 women treated (68.2 per cent) showed quantitative and qualitative improvement of cervical mucus. Results of the Huhner test changed and became positive in 16 cases (39 per cent). Many changes in the estrogen molecule in an attempt to improve cervical mucus only led to decrease in ovulation. But the addition of an aliphatic ether to ethinyl estradio12 causes: (a) twoto threefold increase in estrogen effect over ethinyl estradiol; (b) increased duration of action, i.e., all excreted within 8 days as opposed to 24 hours for ethinyl estradiol; and (c) lack of suppression of ovulation. We found Quinestrol to be successful in the treatment of hostile cervical mucus.s In 75 per cent of our cases there was improved threadibility and in 52 per cent increase in sperm penetration. These findings agree with those of other investigators. We therefore gave combined Quinestrol and clomiphene therapy to those cases of failed clomiphene therapy with a later development of impaired cervical mucus. Small doses of Quinestrol (25 ag) were insufficient and large doses (more than 150 pg) caused suppression of ovulation and cystic hyperplasia. The dose of 50 fig from the sixth to sixteenth day of the cycle was found to be suitable. Of the women in our group 21.9 per cent became pregnant despite their long-term sterility and various treatments including clomiphene over the years, Nausea in a small number of cases was the only side effect of the combined treatment with Quinestrol and clomiphene. We conclude, therefore, that where clomiphene is unsuccessful in promoting pregnancy, and there is deterioration of the cervical mucus, combined clomiphene and Quinestrol therapy will give a much higher rate of success.