Biochemical and Hormonal Assessment of Cervical Mucus Score in Iraqi Women With Primary Versus Secondary Infertility

Background: WHO reports indicate that one in four women in developing countries suffers from infertility. The total fertility rate for Iraqi women is about 4.5 children per woman; other studies have indicated that the maternal fertility rate has been declining in Iraq since 2003 and that war conditions have contributed to this decline. Objectives: To study the relationship between primary and secondary infertility and mid-cycle cervical mucus variables. Materials and Methods: 50 female patients were included in this study; they were recruited from private infertility clinic patients. The patients divided in to two groups: first group25 female with Primary infertility. The second group25 female with Secondary infertility. The serum level of estradiol (E2), lutinizing hormone (LH), follicle stimulating hormone (FSH), and prolactin were measured at the day 2 of cycle (pretreatment). At the same time the cervical mucus (CM) score was done. Results: The results showed no significant differences in demographic data and hormone levels between the primary and secondary infertility groups. There was a significant difference in the mid-cycle estrogen level (p < 0.001) with higher levels in the primary infertility group. There were also significant differences in cervical mucus volume (p = 0.029), consistency (p = 0.046), spinocarcinoma (p < 0.001), cellularity (p = 0.002) and total cervical mucus score (p < 0.001) with higher levels in the secondary infertility group, while there was no significant difference in the ferning and pH change of cervical mucus between the two groups. Conclusions: Most infertility cases were found in women from normal weight, FSH, LH, Prolactin, but E2 and cervical mucus effect and indicate the problem of infertility in our study group.