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Hum. Reprod. Advance Access published online on July 22, 2004
Human Reproduction, doi:10.1093/humrep/deh420
© 2004 by European Society of Human Reproduction and Embryology
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Received January 22, 2004
Revised May 13, 2004
Accepted June 24, 2004

Article

Mifepristone does not induce cervical softening in non-pregnant women

Avraham Ben-Chetrit 1*, Talia Eldar-Geva 2, Tzina Lindenberg 3, Morshed Farhat 4, Shlomo Shimonovitz 4, David Zacut 4, Hadassa Gelber 3, Regine Sitruk-Ware 5, Irving M. Spitz 3

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

* To whom correspondence should be addressed. E-mail: benchet{at}012.net.il.


  Abstract

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.

Keywords: mifepristone; office hysteroscopy; pain scale; RU-486.
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