Abstract
The present study was designed to determine the accuracy of the cervical score for the timing of human chorionic gonadotropin (hCG) administration in in vitro fertilization patients compared to the timing of hCG administration based upon estradiol and ultrasound measurement. Forty-two patients undergoing ovulation induction with human menopausal gonadotropin (hMG)/hCG for in vitro fertilization were studied. A total of 192 cervical scores was obtained together with plasma estradiol levels and pelvic sonography. hCG was given based on estradiol and ultrasound results without knowing the cervical score. An independent decision to give hCG was made based on the cervical score only following a mean of 2.5 days of a cervical score of 9–12 without the examiner's knowledge of estradiol and ultrasound results. This decision was theoretic and was not condidered for the actual timing of hCG. In 16 (38%) of the cases this decision coincided with that based on estradiol and ultrasound. In 24 (57%) of the cases there was a 1-day gap. A direct correlation was found among the cervical score, the plasma estradiol concentration, and the mean diameter of the two leading follicles (P<0.001). The overall distribution of the cervical score grouped according to estradiol levels (<200, 201–400, and >401 pg/ml) was significantly different (P<0.001). The proportion of “mature” cervical scores (score of 11–12) in the three different estradiol groups was 15.6, 34.5, and 68.0%, respectively. In conclusion, independent decisions to give hCG based on cervical score or estradiol and ultrasound were coincident ±1 day in 95% of the cases. These results suggest that the cervical score can be a useful adjunct for monitoring follicle maturation in in vitro fertilization patients when estradiol and/or sonography are not available. The ultimate success of in vitro fertilization cycles monitored solely by cervical score remains to be determined.
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On leave from the Department of Obstetrics and Gynecology, The Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
On leave from Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
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Oelsner, G., Pan, S.B., Barnea, E.R. et al. The value of the cervical score in monitoring ovulation induction for in vitro fertilization: A prospective double-blind study. J Assist Reprod Genet 3, 366–369 (1986). https://doi.org/10.1007/BF01133249
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DOI: https://doi.org/10.1007/BF01133249