The effect of clomiphene citrate treatment on cervical mucus and plasma estradiol and progesterone levels

Abstract

To study the relationship between cervical mucus (CM) quality, postcoital test (PCT) results and plasma estradiol (E2) in clomiphene citrate (CC)-treated women. A subsidiary aim was to study the relationship between CM quality and plasma progesterone (P). Untreated women were compared with oligo-ovulatory patients given CC. Infertility Clinic, Fazakerley Hospital, United Kingdom. Fifty-one untreated patients and 31 women given CC. The treated women were given 50 mg/d CC from days 2 to 6 of their cycle. A CM assessment, a PCT, plasma E2, and P were performed at the anticipated time of ovulation based on at least two previous basal body temperature charts and menstrual patterns. In untreated women there was a very strong tendency for CM quality to improve with rising plasma E2 levels and to worsen with rising plasma P levels. There was a significant association between CM quality and PCT results. Similar results were found in CC-treated women, except that plasma E2 was very significantly higher and there was a significant inverse relationship between plasma E2 and CM quality. High plasma E2 in the periovulatory phase in CC-treated women is a marker for increased sensitivity to and continuing action of the antiestrogen. This impairs the quality of the CM.