Immunoglobulin levels in the cervical mucus of copper intrauterine contraceptive device users.
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Africa↗
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Preliminary testing of the contraceptive collagen sponge.
The results of 3 years of developing the collagen sponge as an intravaginal contraceptive are presented. Postcoital tests were used to evaluate the efficacy of the sponge as a mechanical barrier. Results with the collagen sponge alone were compared to those of the sponge with spermicidal cream or spermicidal solution (acid buffer and zinc) and of spermicidal cream alone. The presence of any motile spermatozoa in the cervical mucus was considered a failure of the barrier method. The collagen sponge alone or with acid and zinc and spermicidal cream alone had failure rates of 22, 20, and 14%, respectively, whereas the collagen sponge with spermicidal cream had a 6% failure rate. The authors conclude that the combination of a mechanical and a chemical barrier is a more effective contraceptive method than a mechanical barrier or chemical agent alone.
Adolescent↗
The frequency of antisperm antibodies in the cervical mucus of women with poor postcoital tests and their effect on pregnancy rates.
PROBLEM: To determine the impact of the presence of antisperm antibodies (ASAs) in the cervical mucus of female partners in couples with unexplained poor postcoital tests (PCT). Furthermore, the efficacy of intrauterine insemination (IUI) in these same patients was determined by pregnancy rates (PRs). METHOD: Pregnancy rates following IUI in patients with infertility and poor postcoital tests, whether the cervical mucus was positive or negative for ASAs, were evaluated. RESULTS: The 6-month PRs were similar in the ASA negative (40.5%) versus the positive (42.4%) group. CONCLUSIONS: It appears that the antifertility effect of ASA may be mainly the immobilization of sperm in the cervical mucus, and thus, performing IUI may effectively correct the problem.
Antibodies↗
[Acquisition of fetal cells from transcervcial cells in early pregnancy and immunocytochemical study].
OBJECTIVE: To study the presence of trophoblast cells in the lower uterus in early pregnancy, identify fetal cells by immunocytochemistry, and determine the best timing for sample collection. METHODS: Samples from healthy gravida in early pregnancy were divided into HE group (I) and immunocytochemistry group (II), and those from healthy nonpregnant women were also divided into HE group (III) and immunocytochemistry group (IV). Four different methods (usage of a cotton swab, aspiration of the cervical mucus, lavage of the endocervical canal, and lavage of the intrauterine cavity) were employed for collecting the samples, which were tested with HE staining or immunocytochemistry, and the presence of fetal cells was observed under optical microscope. RESULTS AND CONCLUSION: Fetal cells were detected in the genital tract of the gravida in early pregnancy. Utilization of the lavage of the endocervical canal or the lavage of the intrauterine cavity allowed greater amount of fetal cell acquisition, and sampling of the fetal cells between 50 days and 79 days of gestational age yielded optimal results. These sampling methods may provide safe and effective means for prenatal diagnosis with minimal invasiveness.
Adult↗
[The family practitioner and the postcoital test].
There is still a great deal of controversy on the value of the postcoital test. Some consider it to be a valuable method for the general practitioner to evaluate the interaction in vivo between spermatozoa and cervical mucus, in spite of the poor predictive value of the test. The postcoital test is in fact only an indirect method for the detection of the production of moving sperms. As a negative postcoital test is frequently due to bad timing of the test, multiple mandatory intercourse is often necessary, which may lead to frustration and sexual dysfunction. Moreover, there are no indications that the postcoital test with its poor discriminatory power may be better in general practice than the fertility evaluations by a specialist as standardisation and reproducibility problems are equal in both settings. Therefore semen analysis appears to be a better option, for the general practitioner as well.
Family Practice↗
Immunological assessment of infertility by estimation of antisperm antibodies in infertile couples.
160 clinical samples were collected from 40 infertile couples with unexplained infertility. The samples collected included serum and seminal plasma of the male partners and serum and cervical mucus samples of the female partners. 25 fertile healthy couples were investigated as controls. All the samples collected were then tested for class-specific antisperm antibodies by an Enzyme linked immunosorbent assay (ELISA). Antisperm antibodies were detected in 30% of the infertile couples which included 25% female and 10% male partners. Amongst the cases positive for antisperm antibodies, antibodies were detected most frequently in female sera 58.4% followed by male sera 33% and 25% in cervical mucus. The isotyping of antisperm antibodies in various samples showed IgG to be the most frequent type specific antibody followed by IgM & IgA types of antibodies. ELISA has provided a relatively simple, reliable and highly reproducible method of detection of antisperm antibodies. Thus application of antisperm antibody testing especially in cervical mucus should become an integral part of the investigation of immunologic infertility.
Adult↗
Disc-electrophoretic protein pattern of cervical mucus in cases of humoral sensitization against spermatozoa.
Midcycle cerevical mucus samples from 20 fertile women with negative, and from 6 infertile women with positive serum-sperm agglutinating activity were subjected to a qualitative protein analysis by the Ouchterlony-technique, to polyacrylamide (PAA) discelectrophoresis and after purification on spermatozoa they were also run against rabbit antihuman serum in the Laurell immuno-electrophoretic technique. By the Ouchterlony method the main serum protein fractions were shown to occur also in cervical mucus. No significant differences could be found in the protein pattern of samples from fertile and infertile females as detected by polyacrylamide (PAA) electrophoresis. In all samples a split protein fraction corresponding to serum albumin and a band preceding the protein fraction corresponding to serum preablumin were observed. In 2 samples from infertile females it could be demonstrated that immunoglobulins occurring in the cervical mucus were directed towards antigenic sperm components.
Cervix Mucus↗
Model-based approaches to studying fertility and contraceptive efficacy.
Statistical methods recently developed to aid in identifying environmental exposures with reproductive toxicity can also be applied to trials of interventions undertaken specifically to impair fertility, i.e. methods of contraception. Although only applicable in a trial that includes a reliable benchmark for identifying the day of ovulation, the proposed measures of contraceptive efficacy derived from such a trial offer certain interpretive advantages over the more traditional approaches of evaluating contraceptives. Extensions of the same models also allow one to evaluate efficacy under any assumed pattern of imperfect use. One can also evaluate methods based on biomarkers for the fertile phase of the cycle, such as hydration of the cervical mucus, that may prove to be enormously helpful to couples who wish to use periodic abstinence as their method. In prospective studies of fertility, couples who occasionally use a barrier method should not be excluded from the study, but can be retained, without biasing the estimates for fertility parameters.
Contraception↗
Long acting methods of contraception.
Long acting methods of contraception have been developed and refined over the last 10 years. From the classical long acting progestogen-only depot preparations we now have a range of delivery systems including both combined and progestogen only injection systems and vaginal rings also containing either progestogen only or oestrogen and progestogen in combination. Subcutaneous implants at present containing only a progestogen, offer a range of durations from 2-5 years. The efficacy of these methods is high, with failure rates as low as 0.1 per 100 woman years. However, with progestogen only systems a significant proportion of women develop unpredictable menstrual bleeding, which with counselling is acceptable. The commonest reason for discontinuation still remains menstrual disorders and recent WHO workshops have investigated the cause of this bleeding and refined the reference periods of analysis. The method of action of progestogen-only systems is primarily cervical mucus blockade and prevention of sperm penetration. However, they also tend to produce a thinned atrophic endometrium. Ovarian effects ranging from complete anovulation to disordered luteal phase, persistent follicles and disorganised hormone production add to the contraceptive effect in more than half of the treatment cycles, but cause some of the menstrual disturbance. All these long acting methods are essential to family planning programmes, offering highly acceptable, and in some cases novel methods with high efficacy.
Administration, Intravaginal↗
Cytokines concentrations in the cervical mucus of pregnant women.
OBJECTIVE: Interleukin-1 alpha, interleukin-1 beta, interleukin-6 and interleukin-8 in specimens of cervical mucus were assayed to assess defense mechanisms against infection in the cervical canal during pregnancy. METHODS: Two hundred and thirty-nine pregnant women who attended the obstetrics outpatient clinic in our hospital were included as subjects. Cervical mucus was collected with a newly developed collection swab, and cytokines and granulocyte elastase in the samples of cervical mucus were quantified using enzyme immunoassay kits. The 1-factor ANOVA, the Kruskal-Wallis test, and scheffé's F were used for statistical analysis. RESULTS: Interleukin-1 alpha, interleukin-1 beta and interleukin-8 levels rose significantly as the concentrations of granulocyte elastase increased. High concentrations of interleukin-1 alpha (75.36 +/- 19.93 pg/ml), interleukin-1 beta (1005.29 +/- 238.75 pg/ml) and interleukin-8 (4822.4 +/- 633.2 pg/ml) were found in the specimens from the group of high granulocyte elastase levels. CONCLUSIONS: These cytokines might be involved in defense mechanisms against ascending infection from the vagina.
Adolescent↗
[Potscoital test (author's transl)].
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Cervix Mucus↗
The postcoital test as a method of evaluating a contraceptive jelly.
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Biology↗
Antibodies to spermatozoa. V. Antibody activity in human cervical mucus.
Efforts were made to seek sperm antibody activity in human cervical mucus (C.M.). A procedure of extraction was developed, as well as methods for measurement of total protein and of immunoglubulin level. The antibody testing was done by the Kibrick (K-B-M) and F-D methods. In clear contrast with negative control serum and negative C.M. samples, positive activity could be found in the C.M. extracts from several infertile women. Some of these manifestations were seen as positive K-B-M agglutination, whereas some were seen either as agglutination or immobilization in the F-D test; hence, three kinds of observation can be indicative of sperm antibody in extracts of cervical mucus.
Antibodies↗
Home monitoring with the ClearPlan Easy Fertility Monitor for fertility awareness.
Many couples planning a pregnancy have had to gauge the best time for sexual intercourse from subjective indications, e.g. cervical mucus changes, or retrospective information, e.g. temperature and calendar methods. Between women, and within a woman, there are considerable variations in menstrual cycle length and underlying hormonal patterns. Although fertility test kits are available, most still rely on visual interpretation by the user. A new combination of immunochemical testing and computing technology is now available in the ClearPlan Easy Fertility Monitor. This paper describes the features of this accurate, simple-to-use, home-based fertility monitor, which gathers data on hormonal patterns and takes account of the individuality of menstrual cycles in women. These data and information about other events, such as sexual intercourse, can be stored in the monitor and accessed by the couple and their medical professional for retrospective review. The monitor is useful for couples who have just started trying to conceive, or those who have been planning a pregnancy for some time.
Estrone↗
Detection of cervical immunoglobulin A in normal pregnancy.
The aim of our study was to evaluate a feasible method to quantify the immunoglobulin A concentration in the cervical mucus of women with a normal singleton pregnancy. In 60 immunologic healthy pregnant women cervical mucus samples were taken at a random time in pregnancy using an absorbing cylindrical cotton-swab stick. In this cervical mucus immunoglobulin A concentration was measured by radial immunodiffusion. A vaginal bacterial swab was taken from each woman. Concentration of immunoglobulins in maternal serum was estimated. There was no statistically significant difference of cervical immunoglobulin A concentration between the investigated groups (p = 0.952): 18-24 gestational weeks (gw): 52.8 (6.6-258.4) mg/l; 25-29 gw: 89.3 (4.8-193.8) mg/l; 30-34 gw: 55 (1.4-326) mg/l; 35-40 gw: 59.2 (4-400.9) mg/l. Women with a normal vaginal flora showed a significantly higher cervical immunoglobulin A concentration than those with a pathological colonization: 92.2 (6.6-400.9) mg/l vs. 42.5 (1.4-326) mg/l (p < 0.05). The serum levels of immunoglobulins A, A1, A2, M and G do not correlate to cervical immunoglobulin A levels nor to gestational age. In normal pregnancy, cervical immunoglobulin A concentration does not change with advancing gestational age, but a pathological vaginal colonization seems to be associated with decreased immunoglobulin A levels.
Adolescent↗
Successful pregnancy despite advanced age and elevated serum follicle stimulating hormone levels--a case report.
PURPOSE: To determine if a woman over age 45 with elevated serum follicle stimulating hormone (FSH) levels in the early follicular phase could still successfully conceive. METHODS: Female partner was treated with guaifenesin to improve cervical mucus quality and vaginal progesterone in the luteal phase. Careful monitoring of follicular maturation was performed. RESULTS: A successful pregnancy after 14 months of progesterone therapy was achieved. CONCLUSIONS: It is possible for a 46-year-old infertile woman with elevated serum FSH to achieve a pregnancy even when the male partner is taking calcium channel blockers for heart problems.
Aging↗
[Electrophoretic analysis (SDS PAGE) of ovulatory cervical mucus in patients with fertility failure and after unsuccessful IVF].
OBJECTIVE: To evaluate the presence and activity of local sperm antibodies and electrophoretic analysis of ovulatory cervical mucus (OCM) to prove the correlation of results of Kremer mucus sperm capillary penetration test and i-MAR (mixed antiimmunoglobulin reaction) test with SDS-PAGE. DESIGN: Retrospective study. SETTING: Department of Obstetrics and Gynecology, Medical Faculty of Charles University, Pilsen. METHODS: 94 patients aged 22-40 (average age 32.3 years) were chosen for our study. Ovulatory cervical mucus was taken from uterine cervical canal in Consultation for Reproductive Immunology. Kremer test and indirect mixed antiglobulin reaction test for IgG, IgA, IgM and IgE were used for detection of sperm antibodies. For the SDS-PAGE analysis, OCM was incubated with sodium dodecyl sulfate. We studied separated protein fractions from OCM. RESULTS: Sperm-capillary ovulatory mucus penetration test (Kremer) was 0-10 cm/hour in our group (average value in patiens without sperm antibodies was 2.43 cm/hour, with sperm agglutinating antibodies 1.4 cm/hour), significant levels (> 45%) of spermagglutinating antibodies were detected in IgA in 6 patients (6.38%), IgG in 5 (5.32%) patients, sperm-cytotoxic levels (IgA and/or IgG) in 5 patients (5.32%); levels of IgE less than 30% in 3 patients (3.19%). Individual immunological factors gained by SDS-PAGE showed the spectrum of various molecular weights with range of 14.4- 350 kDa. The presence of IgG and/or IgA was in 53 cases (56.38%), with 13 ASA positivities (24.53% correlation with i-MAR test) and no ASA activity in 40 cases (75.47%); 6 ASA positive patiens (31.58%) were not detected by SDS-PAGE. CONCLUSIONS: Analysis of 94 OCM by SDS-PAGE showed several significant correlates, but their specifications will be based on further immunoblot research.
Adult↗
The Billings method of family planning: an assessment.
The Billings/ovulation method is a periodic abstinence method of regulating births based on the client's interpretation of changing patterns in secretions of cervical mucus monitored by external self-examination. It was developed in Australia and is now widely promoted overseas. This paper outlines the method's recent history and goes on to discuss its physiological basis, its use-effectiveness as measured in a number of major trials, and some evidence concerning its general acceptability and applicability in family planning programs.
Body Temperature Regulation↗