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PubMed2004

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↗
PubMed1979

[Combined use of colposcopy and cytology].

The widespread view of the nearly absolute accuracy of cervical cytology in the diagnosis of severe dysplasia, carcinoma in situ and small invasive carcinoma is not correct. The rate of cytologically missed cases computed from the first smear only is more than 10%. Using cytology and colposcopy simultaneously in each single case, the errors of one method will be greatly compensated by the other. Presupposition for the compensation, however, is the independent indication for biopsy. In other words, biopsy must be done based on cytological findings, even when colposcopy is unsuspicious. On the other hand a colposcopically suspected and cytologically unsuspected case must also be biopsied. For the gynecological clinic as well as for the gynecological practice, the additional effort resulting from the combined method is easily realizable. For large screening programs, however, the colposcope can be used only as an instrument for target punch biopsies, indicated by pathologic smears.

Carcinoma in Situ↗
PubMed1996

Sperm kinematics of cryopreserved normozoospermic specimens after artificial stimulation.

OBJECTIVES: Cryopreservation of semen is associated with reduced motility after thawing, resulting in a decreased pregnancy rate. Artificial stimulation of motility has been used in fresh semen samples. This study measured the effect of motility stimulants on various motion characteristics and other sperm functions using cryopreserved semen. METHODS: Frozen semen samples from healthy donors were thawed, and motility stimulants were added in vitro and incubated for 60 minutes. The percentages of motile spermatozoa in each specimen and other motion characteristics were measured. In addition, spermatozoon's viability, membrane integrity, and ability to penetrate bovine cervical mucus were studied after addition of stimulants. RESULTS: Percentage motility and all other motion characteristics improved after stimulation with pentoxifylline, caffeine, or 2-deoxyadenosine. Linearity did not significantly differ in the control samples after adding any of the stimulants. Viability, membrane integrity, and penetration ability did not improve significantly and were comparable with control values. CONCLUSIONS: Pentoxifylline, caffeine, and 2-deoxyadenosine can stimulate sperm motility and other motion characteristics. This may be beneficial in the cryopreservation of sperm from normal donors and oligozoospermic patients for use in assisted reproduction.

Caffeine↗
PubMed1987

[Salivary LH as an ovulation indicator: on the value of autopalpation of the cervix uteri for the detection of fertile and infertile days of the cycle].

The validity of autopalpation of the cervix as an indicator of fertility has been studied in 115 cycles of 13 nulliparous and 13 parous women, aged 22 to 35 years and experienced in self-observation methods (SOM) of family planning. For this purpose, the reported cyclic changes of the cervix uteri (hard, closed and low positioned; soft, open and higher positioned or intermediate stages) have been compared with the salivary LH-peak as indicator of ovulation, the BBT-readings and cervical mucus quality. The study has confirmed that in principle it is possible to collect sufficiently reliable self observation data for family planning purposes by autopalpation of the cervix. Parous women detect the first preovulatory changes of the cervix earlier and more frequently than nulliparous. Nevertheless it is not possible for either group to determine the beginning of the fertile days in this way. The beginning of the postovulatory infertile phase, however, can be detected: if, in accordance with rising BBT, the cervix has returned to a hard and closed appearance for 4 days, this symptom signals infertility with the same high degree of accuracy as the third measurement of elevated BBT (BBT3). Thus a "rule of thumb" can be established, linking the beginning of postovulatory infertility to either the fourth day of the hard and closed cervix or to the evening of the day of BBT3, "whatever comes first". In this way, the beginning of the infertile phase could be recognized one to three days earlier by referring to the cervix in about 20% of the cycles.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1979

A simple inexpensive method for objective assessment of human sperm movement characteristics.

A simple, objective method is described for obtaining a well-defined and diversified set of human sperm movement characteristics. These data are suitable for comprehensive statistical comparisons of sperm suspensions. One-second time-exposure photomicrographs are taken with dark-field illumination of slides prepared from semen, cervical mucus, or artificial media. The negatives are projected as a filmstrip and are analyzed on a specially designed console. The filmstrips can be taken and developed in 15 minutes without darkroom facilities, and a complete analysis of the film requires an additional 15 to 20 minutes. Fifty spermatozoa are examined to determine percentage motility, and movement characteristics are recorded for 15 spermatozoa. With these data the swimming trajectories of individual spermatozoa can be reconstructed retrospectively. The sperm suspension as a whole is described in terms of percentage motility, mean swimming speed, percentage of progressive spermatozoa, mean swimming speed of progressive spermatozoa, percentage of straight-swimming spermatozoa, percentage of rolling spermatozoa, and percentage of yawing spermatozoa.

Humans↗
PubMed1980

Effects of RU16117, an orally active weak oestrogenic compound, in postmenopausal women.

Daily oral administration of 1, 3 or 10 mg of RU16117 (11 alpha-methoxy ethinyl oestradiol) to normal postmenopausal women led to a progressive decrease of basal serum LH levels to 60.4 +/- 17.0, 35.1 +/- 9.1 and 20.1 +/- 2.8% of control (pretreatment values, P less than 0.01), respectively, after 4 wk of drug administration. Although the pattern was similar, the inhibitory effect of RU16117 was even more pronounced on FSH than LH levels: a 50% decrease of basal LH and FSH levels was obtained at the daily 1.8 and 1.2 mg doses of RU16117, respectively. No significant change of basal serum gonadotrophin levels was observed with the daily 0.3 mg dose. Administration of 1 mg of RU16117 every second day or 10 mg once a week led to a relatively small but significant (P less than 0.05) 20--25% decrease of basal serum LH levels after 4 wk of treatment in four out of five women. While daily 0.3 and 1.0 mg doses of RU16117 had no significant effect on the LH response to 100 microgram LHRH, the 3.0 mg dose delayed the response up to 90 min. The 10 mg dose, on the other hand, led to a markedly delayed and reduced response. Treatment for the same period (4 wk) with 1 mg RU16117 every second day or 10 mg once a week led to a small (20--25%, P less than 0.05) inhibition of the LH response to LHRH. At the dose of 10 mg once a week, RU16117 had no or minimal effect on endometrial histology. Since RU16117, an orally active weak oestrogenic compound, has been shown to have anticarcinogenic activity in the rat, the present findings suggest that this new steroid could be useful for the treatment of climacteric symptoms.

Aged↗
PubMed2000

The influence of cotinine on interleukin 6 expression in smokers with cervical preneoplasia.

BACKGROUND: Several epidemiological investigations have shown that cigarette smoking leads to increased serum IL-6 levels and is a risk factor for cervical cancer. METHODS: We examined the levels of interleukin 6 (IL-6) and the amount of cotinine in the cervical fluid of 78 women and compared the presence of human papillomavirus (HPV) in smokers and nonsmokers. RESULTS: The results of our study showed that IL-6 levels were higher in the cervical mucus of smokers than in nonsmokers. Fourteen percent of smokers were in the category with highest IL-6 levels compared to 6% of nonsmokers. However, our IL-6 results were not significant as they were probably influenced by the higher rates of HPV infection in smokers (17 cases) than in nonsmokers (4 cases). Significant findings showed that smokers had a higher prevalence of squamous intraepithelial lesions (SILs) than nonsmokers. Smokers' cotinine levels also exceeded those of nonsmokers: 13.95 ng/ml compared with 5.00 ng/ml. However, less IL-6 activity was evident in smokers with high-grade SILs and HPV infection of high-risk types. CONCLUSION: Our results suggest that smoking has a stimulatory effect on the production of IL-6 in the cervix. Furthermore, smokers show a higher genital HPV infection rate and a higher prevalence of SILs.

Adult↗
PubMed1990

[Cervix factors as a cause of infertility].

The uterine cervix plays an important role in the natural fertilization process and, consequently, it is also a significant factor in infertility. In about 6% of infertile couples, the infertility is caused by the cervical factor. The post coital test (PCT) is the most essential diagnostic procedure. A good PCT result excludes the cervical factor as the cause of infertility. A poor or negative PCT result, on the other hand, only indicates that the cervical tract is the cause in the case of women with verified ovulation and in whom other causes have been excluded. Treatment of the cervical factor has always been difficult. Intrauterine insemination is the best documented treatment method with a pregnancy rate of about 30%. In future, gamete intrafallopian transfer (GIFT) and in vitro fertilization (IVF) may be alternatives in the treatment of infertility owing to the cervical factor.

Cervix Mucus↗
PubMed1985

Isolation and identification of actinomycetes from women using intrauterine contraceptive devices.

Of 259 women using intrauterine contraceptive devices 80 (31%) had visible actinomyces-like filaments in their cervical smears. Actinomycetes were cultured from a total of 31 women. Suspicious cultures were identified with the aid of a commercially available kit in conjunction with a computer data base. Culture was found to be less sensitive than microscopical examination of cervical smears in detecting actinomycetes in these women.

Actinomyces↗
PubMed2006

Bayesian selection of predictors of conception probabilities across the menstrual cycle.

There is increasing interest in identifying predictors of human fertility, including environmental exposures, behavioural factors, and biomarkers, such as mucus or reproductive hormones. Epidemiological studies typically measure fecundability, the per menstrual cycle probability of conception, using time to pregnancy data. A critical predictor, which is often ignored in the design or analysis, is the timing of non-contracepting intercourse in the menstrual cycle. In order to limit confounding by behavioural differences between exposure groups, it may be preferable to base inferences on day-specific conception probabilities in relation to intercourse timing. This article proposes Bayesian methods for selection of predictors of day-specific conception probabilities. A particular focus is the case in which data on ovulation timing are not available. We focus on the selection of fertile days in the cycle during which conception probabilities are non-negligible and predictors may play a role. Data from recent European and Italian prospective studies of daily fecundability are presented, and the proposed approach is used to estimate cervical mucus effects within a mid-cycle potentially fertile window using data from the Italian study.

Bayes Theorem↗
PubMed1999

Physicians' knowledge and practices regarding natural family planning.

OBJECTIVE: To assess physicians' knowledge and practices of modern methods of natural family planning. METHODS: A questionnaire was mailed to 840 physicians selected randomly from Missouri state licensing records for obstetrics-gynecology, family practice, general practice, and general internal medicine. RESULTS: The response rate was 65%. A total of 375 physicians (69% of respondents) saw women for reproductive issues. About half (46%) of physicians reported that they mentioned natural family planning to at least some women when discussing family planning issues. Observing vaginal discharge of cervical mucus was discussed by 40% of physicians in the context of avoiding pregnancy and by 36% of physicians in the context of helping a couple achieve pregnancy. Twenty-two percent of physicians estimated the best possible effectiveness of natural family planning to avoid pregnancy to be greater than 90%, and 35% estimated the actual effectiveness to avoid pregnancy to be greater than 70%. (The threshold rates of 90% best possible effectiveness and 70% actual effectiveness were chosen to be somewhat less than those reported in medical literature.) Physicians who gave higher estimates of effectiveness of natural family planning and physicians who were aware of an instructor in their community were more likely to provide women with relevant information about natural family planning. CONCLUSION: Most physicians, especially those unaware of availability of instructors in their areas, underestimate the effectiveness of natural family planning and do not give information about modern methods to women.

Family Planning Services↗
PubMed2000

The physical properties of biogels and their permeability for macromolecular drugs and colloidal drug carriers.

Macromolecular drugs, either free or complexed with colloidal drug carriers, have created a great deal of interest during the last decade. If one wants to administer these new therapeutics via the oral, nasal, and cervical routes or through the conductive airways, one of the first barriers to overcome is the mucus layer that adheres to the related epithelia. In this review, the physicochemical properties of biogels, macromolecular drugs, and colloidal drug carriers that play a major role in transport through biogels are reviewed. Also, methods of studying the mobility of macromolecular drugs and colloidal drug carriers in and through biogels are addressed.

Animals↗
PubMed2007

Interleukin-8 and glucose in amniotic fluid, fetal fibronectin in vaginal secretions and preterm labor index based on clinical variables are optimal predictive markers for preterm delivery in patients with intact membranes.

AIM: Various predictive markers for preterm delivery have been proposed in previous studies. We investigated which marker is most reliable. METHODS: In 126 patients with preterm labor before 32 weeks of gestation and intact membranes, who had regular uterine contractions with cervical changes effaced > or =50%, we evaluated seven markers: interleukin (IL)-8, glucose, and granulocyte count in amniotic fluid (AF); fetal fibronectin (fFN) in vaginal secretions; IL-8 in cervical mucus; cervical length; and preterm labor index (PLI) based on clinical variables. The relationships of these variables to the occurrence of preterm delivery before 34 weeks were examined by logistic regression analysis. RESULTS: Values for AF IL-8, AF granulocyte count, fFN in vaginal secretions, and PLI were significantly higher, while the value for AF glucose was significantly lower, in patients delivering before 34 weeks than those in patients delivering at or following 34 weeks (P < 0.0001 for all). The most sensitive marker for predicting delivery before 34 weeks was AF IL-8 (sensitivity, 67.8%). The most specific markers were AF IL-8 (specificity, 95.5%) and PLI (specificity, 95.5%). By the logistic regression analysis, AF IL-8, AF glucose, fFN in vaginal secretions and PLI showed independent relationships with delivery before 34 weeks (P = 0.0009, P = 0.0032, P = 0.0131 and P = 0.0038, respectively). CONCLUSIONS: In preterm labor with intact membranes, AF IL-8, AF glucose, fFN in vaginal secretions and PLI were highly predictive markers for detecting preterm delivery before 34 weeks.

Adolescent↗
PubMed2004

[Therapeutic effect of Chinese herbal medicines for nourishing blood and reinforcing shen in treating patients with anovulatory sterility of shen-deficiency type and its influence on the hemodynamics in ovarian and uterine arteries].

OBJECTIVE: To observe the clinical therapeutic effect of Nuzhen Yunyu Decoction (NYD, a Chinese recipe for nourishing blood and reinforcing Shen) and its influence on the hemodynamic parameters in ovarian and uterine arteries. METHODS: Sixty-eight patients were randomly divided into two groups at the ratio of 2:1, 45 in the TCM group treated with Chinese medicine and 23 in the control group treated with clomiphene citrate. Menstrual cycle were taken as the indexes for clinical observation; basal body temperature, cervical mucus, vaginal exfoliative cells, serum hormones and B ultrasonic examination were taken as the indexes for ovulation and pregnancy assessment. The hemodynamic parameters of uterus and ovary were determined by using color Doppler ultrasonography, and the growth of follicles and ovulation, thickness of uterine endometrium were also monitored continuously. RESULTS: Results of 3 cycles treatment and 1 year follow-up study showed that the ovulation promoting rate, pregnancy rate and abortion rate in the two groups were similar, but the treated group showed better effects than that of control group, in such aspects as regulating menstruation, promoting growth and development of follicle, strengthening endometrium, improving blood supply and circulation of uterine and ovary (P < 0.05, P < 0.01). CONCLUSION: NYD has the effects of ovulation promotion and holistic regulation of reproductive system.

Adult↗
PubMed2005

[Clinical observation on effect of Chinese herbs in adjusting hypoestrogenemia status by clomiphene to promote ovulation].

OBJECTIVE: To explore the effect of Yijing Huoxue Cuyun Decoction (YHCD) in adjusting hypoestrogenemic response induced by clomiphene. METHODS: Infertile patients caused by ovulation disturbance were randomly divided into 2 groups. The 60 patients in the observed group were treated with clomiphine plus YHCD, and the 58 patients in the control group were given clomiphine plus estradiol valerate. RESULTS: By scoring on the cervical relaxation and improvement of cervical mucus, 38 patients (63.3%) in the observed group had Insler score of more than 8 points, while that in the control group was only 25 (43.1%), comparison between the two groups showed significant difference (P < 0.05). The endometrium thickening in the observed group was 0.98 +/- 0.19 cm, significantly different to that in the control group (0.85 +/- 0.21 cm, P < 0.01). Twenty-five patients in the observed group (41.7%), and fourteen patients in the control group (24.1%), respectively got pregnancy, the pregnant rate in the former was obviously higher than that in the latter (P < 0.05). CONCLUSION: YHCD can ameliorate hypoestrinemia induced by clomiphene and increase the pregnant rate in patients.

Adult↗
PubMed1979

Chlamydiae, cervicitis, and abnormal Papanicolaou smears.

Cervical abnormalities accompanied by Papanicolaou Class II or Class III cytologic results are commonly encountered in gynecologic office practice. Chlamydiae are a common cause of genital tract infection, with or without manifest symptoms or signs. An immunofluorescence method was used to determine the presence of antichlamydial antibodies in cervical secretions. Eleven of 15 patients in whom such antibodies were found (73.3%) had Papanicolaou Class II or Class III smears, in contrast to only 3 of 18 patients (16.7%) without antichlamydial antibodies. The determination of antichlamydial antibodies in cervical mucus was highly reproducible, and specimens were readily collected in the office, without the need of prompt laboratory procedures. In selected patients, tetracycline treatment of early chlamydial infection resulted both in the disappearance of the antibody from cervical secretions and in the reversion of the Papanicolaou smear from Class II or Class III to Class I.

Adult↗
PubMed2004

Human papillomavirus infection and cervical ectopy.

OBJECTIVES: To investigate the prevalence of human papillomavirus (HPV), and HPV type 16 (HPV16) infection in cervical ectopy, and the presence of anti-HPV16 secretory IgA (sIgA) antibodies. METHODS: DNA from patients with cervical ectopy (n=218), HPV-associated lesions (n=111), and controls without evidence of cervical ectopy or HPV infection (n=93) were analyzed by PCR for the presence of HPV and HPV16. The presence of mucosal sIgA antibodies against HPV16 capsid antigens (VLP) was assayed in cervical mucus by ELISA. RESULTS: Prevalence of HPV DNA was higher in cervical ectopy than in controls (P=0.04; OR=2.06; 95% CI 0.99-4.33). HPV16 was 6.3 times more prevalent in cervical ectopy than in controls. Anti-HPV16 sIgA were detected more frequently in cervical ectopy patients than in controls (P=0.0004). CONCLUSIONS: Cervical ectopy correlates with HPV infection. HPV16 is highly prevalent in cervical ectopy. sIgA antibodies against HPV16 capsids are generated in patients with cervical ectopy.

Adult↗