The effect of the estrogen and guaifenesinon cervical mucus and pregnancy outcomes inpatients undergoing ovulation inducation withclomiphene citrate

The aim of this study was to evaluate the effect of guaifenesin, an expectorant drug, and local estrogen use on cervical factors and pregnancy outcomes in anovulatory and unexplained infertility patients undergoing ovulation induction with clomiphene citrate (CC). Method: In this randomized controlled trial, patients who underwent ovulation induction with CC with a diagnosis of primary or secondary infertility between January 1, 2022 and June 30, 2022 at Van Yüzüncü Yıl University were included. The patients were randomly divided into 3 groups of 30 patients each as follows: (i) Klomen 50 mg tablet + Vagifem 25mcg vaginal tablet (C+V), (ii) Klomen 50 mg tablet + Bricanyl expectorant syrup (C+B), (iii) Klomen 50 mg tablet + Vagifem vaginal tablet + Bricanyl syrup (C+B+V) Results: The mean age of the patients was 27.53 ± 4.22 years. Compared to the C+B group, E2 level measured on the second day of the menstrual cycle was significantly higher in the C+B+V group (p = 0.035) and endometrial thickness measured on the day of hCG was significantly lower in the C+V and C+B+V groups (p<0.001). There was no significant difference between the groups in terms of Spinn Barkeit test result, cervical score and clinical outcome (p>0.05). Compared to non-pregnant cases, the age and duration of unprotected intercourse were statistically significantly lower, and the hCG day E2, Spinn Barkeit test and cervical score results were statistically significantly higher in pregnant women (p<0.05). The frequency of pregnancy was statistically significantly higher in women with higher cervical mucus compliance (39.6% vs 8.1%, p = 0.001). Conclusion: Although increased cervical compliance has a positive effect on pregnancy outcome, the use of estrogen or systemic mucolytic drugs has a limited effect on this outcome.