Abuzeid, M. I., Wiebe, R. H., Aksel, S., Shepherd, J., & Yeoman, R. R. (1987). Evidence for a possible cytosol estrogen receptor deficiency in endocervical glands of infertile women with poor cervical mucus. Fertility and Sterility, 47(1), 101-107. https://doi.org/10.1016/s0015-0282(16)49943-7
Abuzeid MI, Wiebe RH, Aksel S, Shepherd J, Yeoman RR. Evidence for a possible cytosol estrogen receptor deficiency in endocervical glands of infertile women with poor cervical mucus. Fertil Steril. 1987;47(1):101-107. doi:10.1016/s0015-0282(16)49943-7
Abuzeid, Mostafa I., et al. "Evidence for a possible cytosol estrogen receptor deficiency in endocervical glands of infertile women with poor cervical mucus." Fertility and Sterility, vol. 47, no. 1, 1987, pp. 101-107.
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4 of 5 women with poor mucus had a negative estrogen receptor test
4 of 5 women with poor cervical mucus tested negative for estrogen receptors in cervical tissue. This 1987 study covered 13 infertile women at one clinic. Most of the eight women with excellent mucus tested positive. Blood estrogen and progesterone were comparable between the groups.
Key Findings
Mucus scores averaged 4.6 in the five women with persistently poor mucus (group 1) and 11.6 in eight ovulatory women with excellent mucus (group 2) (P < 0.01).
The estrogen receptor test was negative in four of the five women in group 1. In group 2, six women tested positive, one borderline, and one negative.
Mean blood estradiol and progesterone levels around the day of biopsy were comparable between groups. Follicle size that day did not differ statistically.
With the borderline woman in group 2 counted as negative, the receptor difference was not statistically significant. Counted as positive, the difference was significant (P = 0.031).
Interpretation
This 1987 study compared two groups of infertile women at one university clinic. Each woman had one cervical biopsy, timed to her cycle. The authors write that the result suggests estrogen receptor deficiency in some women with poor mucus. Group 1 excluded women with a prior cone biopsy or infection. Group 2 had other infertility factors, such as tubal factor or endometriosis. The authors note that unoccupied estrogen receptors may sit mainly in the cell nucleus, so the cytosol test used here may miss some of them. The findings support larger studies of endocervical estrogen receptor status in women with poor cervical mucus.
RRM Context
Cycle-charting methods observe cervical mucus in every cycle. RRM treats persistently poor mucus as a finding with a cause to find. Cervical factor contributes about 5% to 10% of infertility, the authors report. This paper names endocervical estrogen receptor deficiency as one possible cause.
Our editorial summary of this paper, not the article's abstract.
Abstract
Endocervical gland estrogen receptor (ER) deficiency has been proposed as a possible cause for the poor cervical mucus (CM) in some infertile women with cervical factor. Cytosol ERs were measured in endocervical tissue obtained by biopsy within 3 days of ovulation (determined by the endogenous luteinizing hormone [LH] surge) in five infertile women with persistent poor preovulatory CM (group 1) and in endocervical tissue obtained in the late follicular phase in eight ovulatory women with excellent CM (group 2). ER concentrations were measured in Fmol/mg protein by the dextran-coated charcoal separation method (New England Nuclear Kit, Boston, MA). CM score evaluation and measurement of serum estradiol (E2) and progesterone (P) levels were performed concomitantly. Serum E2 levels of 123.4 +/- 29.3 pg/ml (mean +/- standard error of the mean [SEM]) in group 1 were comparable to E2 levels of 123.3 +/- 15.0 pg/ml in group 2. Serum P concentrations of 0.9 +/- 0.27 ng/ml in group 1 were comparable to 0.79 +/- 0.29 in group 2. A CM score of 4.6 +/- 0.69 in group 1 was significantly lower than 11.6 +/- 0.53 in group 2 (P less than 0.01). The cytosol ER was negative in four of five women in group 1, whereas in group 2, ER was positive in six, borderline in one, and negative in one subject. This study suggests that cytosol ER may be deficient in some women with cervical factor.
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