ABSTRACT: The cervical factor was evaluated in 52 infertile women with clinical signs of cervicitis. An abnormal postcoital test (PCT) was observed in 62% of the patients. Bacterial cultures from the cervix in these patients did not reveal any abnormal flora that could be held responsible for the abnormal PCT. The occurrence of Chlamydia trachomatis in four patients was comparable with the isolation rate in a general gynecologic out-patient clientele. Increased levels of antichlamydial antibodies did not correlate with the result of PCT.
On the other hand, 81% of the patients had colposcopically observed abnormalities, including an atypical transformation zone in 21%. Colposcopically directed biopsy specimens revealed severe inflammatory changes in 89% of the patients. Cervical intraepithelial neoplasia (CIN) grade 1 (mild dysplasia) was diagnosed in 11 (21%) patients. Treatment with cryocautery and tetracycline resulted in significant improvement in the result of PCT in 38% of the patients. The results indicate that cervical inflammatory disease in women with unexplained infertility must be carefully and extensively evaluated and treated, which often results in better outcome of the PCT.