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Cervical mucus secretions on the day of intercourse: an accurate marker of highly fertile days.

OBJECTIVE: To provide estimates of the probabilities of conception according to vulvar mucus observations classified by the woman on the day of intercourse. STUDY DESIGN: Prospective cohort study of 193 outwardly healthy Italian women using the Billings Ovulation Method. Outcome measures include 161 conception cycles and 2594 non-conception cycles with daily records of the type of mucus and the occurrences of sexual intercourse. RESULTS: The probability of conception ranged from 0.003 for days with no noticeable secretions to 0.29 for days with most fertile-type mucus detected by the woman. The probability of most fertile type mucus by day of the menstrual cycle increased from values <20% outside of days 10-17 to a peak of 59% on day 13. CONCLUSION: Regardless of the timing of intercourse in the menstrual cycle, the probability of conception is essentially 0 on days with no secretions. This probability increases dramatically to near 30% on days with most fertile-type mucus, an association that accurately predicts both the timing of the fertile interval and the day-specific conception probabilities across the menstrual cycle.

Cervix Mucus↗

Role of alkaline phosphatase in contraception--a review.

High-level influence of alkaline phosphatase (AP) in the endometrium is responsible for conception. Absence or reduction in the level of the same in the endometrium is one of the causes of conception control. The above mechanism is correlated with the observation of Gautray et al. (1969) on "qualitative curve of alkaline phosphatase upon the human endometrium" and the theory of "Rhythm Method"--a role in the fertility control. Conception takes place generally between the 9th and 20th day of the menstrual cycle which is indicated "Baby Days" as the enzymic AP level in the endometrium is helpful for conception and its peak level is between the 16th and 18th day. From the 1st to 8th and 21st to 28th day of the said cycle AP is at low level and almost nil. Implantation becomes unsuitable at this stage and is indicated "No Baby Days". Therefore, it may be concluded that the enzymic influence of AP is responsible both for conception and for contraception. Combined hormonal contraceptive drug also abolishes the AP influence in the endometrium. An attempt at exploration of its essential role is fundamental, because its inadequacy in the endometrium is a factor controlling conception. In view of the documents, it can be concluded that the role of AP uterine enzyme cannot be ruled out with respect to fertility control mechanism which may be considered as a fourth point instead of the three factors for the same, established in medical science.

Alkaline Phosphatase↗

Contraceptive use by Maori youth in New Zealand: associated risk and protective factors.

AIMS: To identify risk and protective factors associated with consistent contraception use by sexually active Maori youth. METHODS: Secondary analysis was undertaken utilising Youth2000, an anonymous nationally representative secondary school health and wellbeing survey, undertaken in 2001. We describe the self-reported sexual health and contraceptive use behaviours of Maori students. A multiple logistic regression model was utilised to identify risk and protective factors associated with consistent contraception use by sexually active Maori students. RESULTS: Half of the Maori students have had sexual intercourse (54% males; 48% females) and a third are currently sexually active (33% males; 34% females). Most Maori youth who have ever had sex use condoms for contraception (82%) and most sexually active Maori youth reported consistent use of contraception (71% males; 70% females). Maori youth who use contraception consistently are more likely to report getting enough time with a parent (OR 1.50; 95% CI 1.05-2.14; p=0.03) and less likely to report weekly marijuana use (OR 0.53; 95% CI 0.37-0.76; p=0.0006). CONCLUSIONS: Consistent use of condoms is a common self-reported contraceptive practice by many young Maori. However this behaviour is not universal, and in view of the significant sexual and reproductive health disparities that exist for Maori youth, sexual and reproductive health programs should examine a broader strategy of promoting protective factors such as strengthening youth-parent relationships and reducing risk factors, such as minimising substance misuse. Together with existing efforts in education, whanau (family), and community based programs, these strategies may support healthier sexual health outcomes for Maori youth.

Adolescent↗

Evaluating client autonomy in natural family planning.

A critical element for evaluation of natural family planning (NFP) methods is client autonomy. Autonomy in NFP refers to clients who can identify their fertile days and apply this method without teacher assistance. The results of this study show that clients who are autonomous have a 12-month continuation rate of 96.7% and a pregnancy rate of 1.7% after beginning charting. The non-autonomous clients had a 12-month continuation rate of 34.3% and a pregnancy rate of 24.8% after beginning charting, significantly different from the autonomous clients. Using a bivariate analysis, we found that women 30 years and older who had two children or more, and women in the same age group (30 years and older) who wanted to limit rather than space pregnancy were significantly more likely to become autonomous. These findings have implications for NFP programs and future evaluation efforts.

Adult↗

Natural family planning effectiveness in Belgium.

The aim of the study was to check, in a European environment, the practical efficiency and the acceptability of a recent natural family planning (NFP) method. This method includes a double check to detect the beginning as well as the end of the fertile phase of the menstrual cycle. Up to now, 71 women of reproductive age have been registered. They agreed to provide their symptothermal charts and related information. Average age is 32 years. Average fertility is 2 children/woman. Fifty-nine percent of the participants have a professional occupation. The same percentages are found in those accepting a contraceptive method (oral contraceptives or intrauterine devices). Until today 1240 cycles (103 women-years) of experience have been gathered. The average participation was 17.5 cycles/woman. No method failure has been reported. One unintended pregnancy due to unprotected sexual intercourse during the fertile phase occurred (user failure). Overall Pearl Index (PI) was 0.96. In 84% of the cycles, no protected intercourse was reported (NFP only). According to PI, practical efficiency of the NFP method analyzed was 1.31. Sexual abstinence during the fertile phase was found in 71.4% of the cycles.

Adolescent↗

Opinion: natural family planning and the management of infertility.

Reproductive behaviour in modern western society has changed dramatically in the last two decades. Parenthood is now well planned. If planned pregnancies do not occur as expected, early infertility care is often demanded with the risk of over-treatment. Live birth rates in untreated subfertile couples reach nearly 55% in 36 months. During this period, self-monitoring with natural family planning (NFP) methods may be all that is necessary, especially in couples with unexplained infertility.

Family Planning Services↗

A comparison of the fertile phase as determined by the Clearplan Easy Fertility Monitor and self-assessment of cervical mucus.

The purpose of this study was to compare the fertile phase of the menstrual cycle as determined by the Clearplan Easy Fertility Monitor (CPEFM) with self-monitoring of cervical mucus. One-hundred women (mean age = 29.4 years) observed their cervical mucus and monitored their urine for estrogen and luteinizing hormone metabolites with the CPEFM on a daily basis for 2-6 cycles and generated 378 cycles of data; of these, 347 (92%) had a CPEFM peak. The beginning of the fertile window was, on average, day 11.8 (SD = 3.4) by the monitor and day 9.9 (SD = 3.0) by cervical mucus (r = 0.43, p < 0.001). The average first day of peak fertility by the monitor was 16.5 (SD = 3.6) and by cervical mucus 16.3 (SD = 3.7) (r = 0.85, p < 0.001). The mean length of the fertile phase by the monitor was 7.7 days (SD = 3.1) and by cervical mucus 10.9 days (SD = 3.7) (t = 12.7, p < 0.001). The peak in fertility as determined by the monitor and by self-assessment of cervical mucus is similar but the monitor tends to underestimate and self-assessment of cervical mucus tends to overestimate the actual fertile phase.

Adolescent↗

Complete sequence of Litopenaeus vannamei (Crustacea: Decapoda) vitellogenin cDNA and its expression in endocrinologically induced sub-adult females.

The gene that encodes vitellogenin (Vg), the precursor of the major yolk protein, vitellin, is expressed during vitellogenesis in decapod crustaceans. In this study, we sequenced the full-length cDNA from the Pacific white shrimp Litopenaeus vannamei Vg gene (LvVg). This is the first open thelycum penaeid shrimp Vg cDNA to be sequenced. The transcript encodes a 2587 amino acid polypeptide with up to 85% identity to Vg of different penaeid species. Peptide mass fingerprints (PMFs) of the vitelline polypeptides suggest that the predicted endoprotease cleavage site at amino acids 725-728 does indeed undergo cleavage. Five prominent high-density lipoprotein polypeptides of masses 179, 113, 78, 61, and 42kDa were isolated from vitellogenic ovary, and their PMFs were determined by matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) spectrometry. It is likely that these polypeptides are all products of the LvVg gene. Removal of the X-organ sinus gland complex (XO-SG), which secretes the neurohormones that control the endocrine system regulating molt and reproduction, can induce both these processes. During the course of a number of molt cycles in induced sub-adult females, periodic ovarian growth and resorption were observed. Ovary growth correlated with LvVg expression in both the hepatopancreas and the ovary. Expression in ovaries of induced intermolt-early premolt females was significantly higher compared to all other sub-groups. Expression in ovaries of induced females was significantly higher compared to hepatopancreas at all molt cycle stages. Periodicity of molt and vitellogenesis in endocrinologically induced sub-adult shrimps may serve as a model to study alternate regulation of gene expression during these two processes.

Amino Acid Sequence↗

An estrogen test to determine the times of potential fertility in women.

Defined changes in the concentration of estrone glucuronide in daily samples of early morning urine have been used to locate the limits of the fertile period and the time of maximum conception probability during 118 cycles (106 menstrual, 12 conceptional) in 73 women. The peak day of urinary luteinizing hormone was used as an index of ovulation. Follicular growth was monitored daily by ultrasonography throughout 38 cycles, and the time of maximum follicular diameter was used as an alternative reference point to define the times of potential fertility according to the life spans of the gametes. With optimized algorithms and the best index of ovulation, the estrogen test delineated the limits of the fertile period in 89% of the tests (mean length, 10.8 days; range, 5 to 17 days) and the time of maximum conception probability in 82% of the cycles, with a mean time to the maximum follicular diameter of 0.42 days (range, -4 to +4 days).

Adult↗