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Cyclic adenosine monophosphate normally stimulates motility of spermatozoa. Its concentration in cervical mucus was studied by an isotopic competitive method in 15 normal women aged between 20 and 50 years. Values were very high, particularly in the periovulatory period, with a mean (+/-SD) value of 167.90 +/- 154.96 nmol/l. These are very high when compared with values in other biological fluids (blood serum and urine).
Female genital tract is a major area of anaerobic infections. Clindamycin has been used as a highly active antibiotic against both gram positive and negative anaerobic pathogens including bacteroides fragilis. Concentration of clindamycin in cervical mucus has been tested in 30 women after administration of one single dose (600 mg) of the antibiotic intramuscularly. Antibiotic levels were tested by agar diffusion method employing a strain of alpha-hemolytic streptococcus. Levels of clindamycin in cervical mucus were found to be sufficient to inhibit "in vitro" a significant proportion of anaerobic bacteria present in cervical mucus.
OBJECTIVE: To compare levels of sperm-agglutinating antibodies in male and female sera, cervical ovulatory mucus, and seminal plasma by two different tests. PATIENTS AND METHODS: 408 women and 404 men with long-lasting unexplained infertility and recurrent IVF failure were immunologically examined. Tray agglutination and mixed antiglobulin reaction tests were used for the comparison of sperm-agglutinating antibodies in sera, in ovulatory cervical mucus, and in seminal plasma. RESULTS: High secretory IgA positivity predominated in seminal plasma in 16 (3.9%) of infertile men and in cervical ovulatory mucus in 114 (27.9%) of infertile women. Positivity in two sperm antibodies together, in IgG and IgA, and IgM and IgE was also observed. Immunological anti-sperm antibodies in sera indicate high levels of sperm antibodies in IgG and IgM. CONCLUSION: Sperm immunoglobulin specification is important for therapeutic influence upon immunocompetent cells.
OBJECTIVES: Characteristics of cervical mucus during monofollicular stimulation of ovulation by clomiphene citrate and by clomiphene citrate with HMG was evaluated. MATERIALS AND METHODS: 226 women of couples treated for male factor infertility or idiopathic infertility were studied. Favourable parameters of cervical mucus in women treated by clomiphene citrate with HMG were found although they were worse than observed in spontaneous ovulatory cycle. RESULTS AND CONCLUSIONS: The E2/follicle index was used for evaluating efficiency of stimulation. It was the highest during cycles were CC and HMG were used, although they did not reflect the risk of hyperstimulation. Authors discuss the importance of their findings in cases when techniques of ART can not be applied.
Bacteriological findings obtained by the Cryo-method of cervical smears before and after the treatment of cervicitis and ectopia in the vaginal part of the uterine cervix of 64 women revealed certain essential changes. Before the Cryo-therapy, pathogenic microorganisms were verified in 49 patients (76.56%), while saprophytic flora was isolated from 15 patients (23.45%). After the treatment, this proportion was significantly changed: saprophytic flora was isolated from 45 patients (70.34%), while pathogenic flora continued persisting in 19 patients (29.67%). Eight weeks following the treatment, instead of a dense, non-elastic, opaque, cellular secretion before the Cryo-therapy, a clear elastic, acellular mucus was recorded.
OBJECTIVE: To evaluate the ability of leukocyte esterase dipstick test (LET) performed in cervical mucus to predict direct immunofluorescent (DIF)-verified Chlamydia trachomatis (Ct) cervical infection. METHOD: Eighty women with inflammatory cervico-vaginal smear were submitted to both an endocervical smear, to verify Ct cervicitis by DIF technique; and a cervical mucus sample to perform LET. Results of LET and DIF were matched. RESULTS: Among 30 Chlamydial positive subjects, cervical mucus esterase test was positive in 28 (93.3%); while among 50 Chlamydial negative controls, esterase test was negative in 43 subject (86%). The sensitivity, specificity, positive and negative predictive values for LET were 93.3%, 86%, 80% and 95% respectively. CONCLUSION: Cervical mucus LET is a simple, cost effective screening test, with promising accuracy, for Ct cervical infection among women with inflammatory cervico-vaginal smears.
Ultrasound (US) has been demonstrated to be the method of choice for diagnosing luteinized unruptured follicle syndrome and to be a valuable adjuvant in the assessment of luteal phase defect. In this prospective study, the use of US with postcoital testing (PCT) is evaluated. Fifty control infertility patients were examined with serial US for follicle dynamics in conjunction with PCT. Standard curves for follicle dynamics versus cervical mucus quality (Insler score) were calculated. Eighteen patients referred for abnormal mucus underwent similar evaluation. Their follicle dynamics versus mucus quality were compared with those of the controls. The findings were: (1) there is a predictable relationship between follicle size and mucus quality, (2) the majority of patients with abnormal mucus have normal follicular dynamics, and (3) a minority of patients with abnormal mucus have either a narrow mucus window or abnormal follicular dynamics. In addition, US was found to be cost-effective in the overall fertility evaluation.
A new urine luteinizing hormone (LH) kit, First Response (Tambrands Inc., Palmer, MA) was compared with basal body temperature (BBT), cervical mucus scoring and abdominal ultrasound follicular scanning in their ability to predict ovulation to within 2 days of the serum LH peak. BBT was kept daily. From day 10 daily ultrasound scanning and cervical mucus examination were performed and serum oestradiol, luteinizing hormone, follicular stimulating hormone and progesterone were assayed. First Response was significantly more accurate than BBT and cervical mucus when compared in their ability to predict ovulation to within 2 days of the LH peak (p less than 0.05). First Response pinpointed 93% (27/29) of the ovulatory cycles compared to 72% (18/25) and 61% (19/31) for BBT and cervical mucus respectively. It was better but not significantly so against abdominal ultrasound which predicted 77% (24/31). The implications of this finding and the value of the other simple office tests in clinical practice are discussed.
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Specimens of cervical mucus from 7 women fitted with copper IUDs were placed immediately after collection in liquid nitrogen. These specimens were shown by electron paramagnetic resonance measurements to contain statistically significantly higher concentrations of free radicals than similar specimens from 6 women fitted with plastic Lippes loops. Cervical mucus, collected from women immediately prior to elective removal of an IUD, was placed in 2M hydrochloricacid and later analyzed for malonaldehyde using a newly developed polarographic method. Positive results were obtained for 8 of 19 women fitted with copper IUDs, but for none of 21 women fitted with plastic devices. Cervical mucus was similarly collected from 10 women fitted with copper IUDs, 9 women fitted with plastic IUDs, and an additional 9 using other methods of contraception. Mucus was collected 3 times (early, middle, and late cycle). No malonaldehyde was detected in mucus from women with plastic IUDs, or other contraceptive methods. Positive results were obtained in 13 of 29 mucus specimens from those using copper IUDs. Stage of menstrual cycle did not influence the percentage of positive results. Malonaldehyde was detected in vitro in solutions of arachidonate or prostaglandin F2alpha in buffered saline incubated with sterile copper IUD, but not with the plastic. Rate of malonaldehyde production was markedly influenced by pH, temperature, agitation, substrate concentration, and size of gas-liquid interface. the rates of malonaldehyde production around the copper IUD in utero are unknown. The possible increased risk of carcinogenicity associated with the copper IUD is discussed.
Natural family planning (NFP) methods can be effective if taught well and practised by well-motivated couples. Midwives should be able to give couples an understanding of the basic principles of the methods. The observable signs of the fertile cycle are changes in basal body temperature, in the consistency of cervical mucus and in the texture and position of the cervix. Practised properly the ovulation method can have a failure rate of as little as 2.2 pregnancies per 100 woman-years. The ovulation method is a suitable method for mothers who have breastfed to detect the onset of ovulation.
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Cervical mucus was collected from 24 normal (control) women, and 45 cases fitted with Cu T200 IUDs. Glucose concentration was measured by spectrophotometry before and after insertion of the IUDs. In the control group, glucose concentration at midcycle was 1.802 +or- 0.235 mg/gm wet weight cervical mucus. Pre- and postinsertion mean values in Cu T200 users were 0.746 +or- 0.149 mg/gm and 0.487 +or- 0.045 mg/gm of mucus respectively. This decrease in mucus glucose concentration in Cu T200 users may be a factor by which this device affects sperm migration at the cervical level.
35 women of proven fertility who were scheduled for surgical sterilization by salpingectomy were selected for this study; 15 control patients, 10 patients using the Multiload (ML) Cu 250 IUD, and 10 fitted with nonmedicated IUDs. Increased copper concentration did not affect sperm receptivity by the cervical mucus, but did significantly affect sperm motility and survival. Nonmedicated IUDs did not interfere with sperm transport in the oviduct. ML Cu IUDs inhibited sperm transport in the oviduct. The effects of the ML Cu IUD on sperm migration were more evident at the tubal level than at the cervical level.
Human cervical mucus from women using Lippes Loop and T-Cu-200 IUDs was used to study sperm migration in vitro using flat capillary tubes. Cervical mucus from women bearing no IUD was used as the control. 100% of the control samples, 83% of the Lippes Loop users, and 88% of the T-Cu-200 users had more than 100 spermatozoa/field of 100x. In 17% and in 11% there were between 40 and 100 spermatozoa/field of 100x in the Lippes Loop and T-Cu-200 users. The presence of copper IUDs does not interfere with sperm migration in vitro through human cervical mucus.
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