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Hum. Reprod. Advance Access originally published online on July 22, 2004
Human Reproduction 2004 19(10):2372-2376; doi:10.1093/humrep/deh420
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Human Reproduction vol. 19 no. 10 © European Society of Human Reproduction and Embryology 2004; all rights reserved

Mifepristone does not induce cervical softening in non-pregnant women

Avraham Ben-Chetrit1,2,5, Talia Eldar-Geva2, Tzina Lindenberg3, Morshed Farhat1, Shlomo Shimonovitz1, David Zacut1, Hadassa Gelber3, Regine Sitruk-Ware4 and Irving M. Spitz3

1 Women's Health Center-Ramat Eshkol, 2 Department of Obstetrics and Gynecology, and 3 Institute of Hormone Research, Shaare Zedek Medical Center, Jerusalem, Israel and 4 Center for Biomedical Research, Population Council, New York, NY, USA

5 To whom correspondence should be addressed at: Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel 91031. Email: benchet{at}012.net.il

BACKGROUND: Many techniques have been developed to soften the cervix to reduce complications following surgical dilatation. Progesterone inhibits myometrial contractility and its secretion during pregnancy ensures cervical competence. We used the progesterone antagonist mifepristone as a cervical ripening agent and evaluated its effect prior to office hysteroscopy. METHODS: Fifty-eight healthy non-pregnant women aged 18–50 were studied in a randomized double-blind study. They received mifepristone (200 mg) or placebo 30 h prior to hysteroscopy. A Hegar test was performed prior to drug administration and again before hysteroscopy. A visual analogue pain scale was used to assess pain. RESULTS: Medical history, physical examination and blood tests were similar in both groups, except for serum progesterone which was higher in the study group. Hegar measurement prior to drug ingestion was similar in both groups and after a mean time of 30.3 h increased in both groups. Neither the {Delta}Hegar measurement nor the pain scale was different in the two groups. There was also no effect of the high progesterone levels. CONCLUSIONS: Unlike its dramatic effect in the pregnant uterus, mifepristone administered 30 h prior to hysteroscopy was not effective in ripening the cervix of non-pregnant women.

Key words: mifepristone/office hysteroscopy/pain scale/RU-486


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M. Vaisanen-Tommiska, R. Butzow, O. Ylikorkala, and T. S. Mikkola
Mifepristone-induced nitric oxide release and expression of nitric oxide synthases in the human cervix during early pregnancy
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