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PubMed1998

Silent premature rupture of membranes, detected and monitored serially by an AFP kit.

A 24-year-old woman underwent conization and cervical cerclage during pregnancy. After she later complained of fluid leakage, a premature rupture of the membranes (PROM) was suspected, because of positive results on a test for nitrazine, the intra-amniotic dye injection method (PSP test), and an AFP-kit test at 22 weeks of gestation. The nitrazine and PSP tests later turned negative. However, during the period from the 22nd through 26th weeks of gestation, the results of AFP-kit tests fluctuated, with repeated positive indications for bacterial cultures and elevated granulocyte elastase activity in the cervical mucus. The pregnancy was well maintained with administration of antibiotics and ritodrine hydrochloride until 34 weeks of gestation. The presence of chorioamnionitis, local inflammation of the fetal membranes, was found by pathological examination after the delivery. We propose a new clinical entity--to be referred to as silent PROM--the premature chemical rupture of the membranes.

Adult↗
PubMed2001

Synthetic polymers alter the structure of cervical mucus.

Mucosal sites have an innate defense system--which includes immune cells, antibodies, and mucus--to protect the body from opportunistic pathogens. Some sexually transmitted diseases (STDs), such as HIV, utilize host defense mechanisms to evade detection by infecting motile immune cells present at the site. The infected cells migrate through the mucus layer and penetrate the epithelium undetected. A new strategy for preventing STDs could involve inhibiting cell migration through the mucus. One method for inhibiting migration is to alter the barrier property of mucus by modifying its gel structure. Mucin, the structural component of mucus, is a high molecular weight anionic molecule, which forms an entangled fiber network through non-covalent interactions. The addition of nonionic or cationic polymers, such as poly(ethylene glycol) (PEG) or poly(vinyl pyridine) (PVP), altered the overall gel structure as revealed by scanning electron microscopy (SEM), while anionic poly(acrylic acid) had little effect on the structure. Acid residues on mucin associate with PEG through hydrogen bonds to form regions of coalesced fibers within the mucus. PVP, however, interacts with mucin via electrostatic bonds, forming a gel that had areas of aggregated fibers adjacent to regions with virtually no fibers. These results suggest that addition of small amounts of certain synthetic polymers will modify mucus structure; these changes should alter the barrier properties of mucus.

Animals↗
PubMed1981

Monitoring of ovulation induction with human menopausal gonadotropin and human chorionic gonadotropin by ultrasound.

Ovarian follicular growth was monitored by ultrasound and plasma estradiol levels in 43 cycles of 27 patients. These women were treated with human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG) for anovulation or poor cervical mucus. Ultrasonography can help to prevent multiple pregnancies by allowing the withholding of the ovulatory injection of hCG if the number of mature follicles is too great. Nevertheless, mild to moderate hyperstimulation cannot always be prevented; it is sometimes the price one has to pay to obtain a pregnancy. Giving a direct view of follicular maturation, this method can be helpful in the determination of the best time for the induction of ovulation.

Chorionic Gonadotropin↗
PubMed2005

Body composition, dehydroepiandrosterone sulfate and leptin concentrations in girls approaching menarche.

UNLABELLED: There is strong evidence that the initiation of adrenarche and gonadarche during puberty in girls depends on body mass in general and body fat in particular. The aim of this study was to analyze changes in body composition, i.e. body fat (BF), fat percentage (BF%), and lean tissue mass (LM) in girls during pre-menarcheal stages of development, including the earliest stage lacking clinical manifestations of changes in primary, secondary, and tertiary sexual characteristics. Puberty was assessed according to clinical and ultrasonographic staging of sex features developed by us. Concentrations of leptin and DHEA-S were compared and related to changes in body composition. SUBJECTS AND METHODS: The study was carried out on 65 healthy girls aged 8 years and older who were followed every 3 months over a 5-year period. Age, height, weight, and BMI were recorded. Body composition (BF, BF%, LM) was determined with an infrared method. Tertiary sexual features were staged according to Tanner. Vaginal secretion was assessed according to Peter et al. Transabdominal ultrasound of the uterus and ovaries was performed with the bladder unvoided. Groups were formed according to developmental stage: E0A = pre-estrogenization (no ultrasonographic or clinical evidence of estrogenization); E0B pre-estrogenization with 'luminosity' of mucus in cervical canal; E1 = onset of estrogenization; E = full estrogenization; M = menarche +/- 3 months. Concentrations of DHEA-S and leptin were determined by radioimmunoassay. RESULTS: BF in prepubertal girls averaged 16%. At menarche, BF was 23.9%. Body weight at menarche was 50.6 kg and the LM/BF ratio was 3.0. High leptin concentrations were found in E0B and M groups. Leptin concentrations were lowest during full estrogenization (E). Positive correlations of leptin with BF and LM were found in girls during developmental stages preceding menarche. Mean concentration of DHEA-S started at 1,091.6 microg/l during E0A stage, dropped significantly on passing to E0B (p <0.05), and increased by menarche. DHEA-S levels were found to correlate with BF, LM, and leptin in E0A, E0B, and E1 groups. Correlation coefficients were highest (DHEA-S/BF r = 0.61; DHEA-S/LM r = 0.54; DHEA-S/LEP r = 0.57) in the E0A group, i.e. about 5 months before the appearance of 'luminosity' of cervical mucus, considered to be the first ultrasonographic sign of puberty. Apparently, leptin stimulates somatic maturation during this stage of gonadarche which terminates with menarche. The action of DHEA-S is exerted during the early stages of female puberty.

Adolescent↗
PubMed2004

[Noninvasive methods used in prenatal diagnosis].

Research in developing methods for noninvasive prenatal diagnosis has focused on the following: the isolation of fetal cells from the cervix, from the blood of pregnant women and the isolation of the fetal DNA. In the paper authors review the potential clinical diagnostic applications of fetal cells and fetal DNA analysis in maternal plasma or serum and fetal cells in cervical mucus for noninvasive prenatal diagnosis and screening of fetal aneuploidy, gene mutations, preeclampsia and preterm labor.

DNA↗
PubMedDate not supplied

The M.A.R. test role for a rapid detection of antisperm autoimmunization in infertile men.

We examined 44 men from couples with negative or dubious P.C.T. which had not been caused by cervical pathology (infection, malformative pathology or insufficient mucus production) or seminal pathology (no infection present, normal seminal liquid and in some cases at the most a slight asthenospermia). 40,9% of the men were classified as immunized. This was established by the results of seric T.A.T. and other tests. The M.A.R. test has proved to be a good method for the screening of immunization in those with a low sperm-motility; in fact results proved either positive or strongly positive in 83,3% of immunized subjects. Considering as positive the M.A.R. tests which were "doubtfully positive", the final results proved positive in 94,4% of immunized subjects.

Adult↗
PubMedDate not supplied

Cytologic atypias in the uterine fluid of intrauterine contraceptive device users.

A peculiar cell pattern, characterized as an atypical glandular cell cluster (AGCC), was found in the uterine fluid from women using intrauterine contraceptive devices (IUDs). This atypia can mimic adenocarcinoma. Since the atypical cells were present in much higher frequency in the uterine fluid than in the cervical mucus, it is suggested that they originated in the endometrium.

Body Fluids↗
PubMed1988

Clinical evaluation of the new sperm antibody slide-test for detection of antibodies to spermatozoa in cervical mucus and seminal plasma.

A new commercially available Sperm Antibody Slide-Test kit for the detection of antibodies to sperm (Biotec Diagnostica International GmbH, Hannover, FRG) was evaluated with respect to its diagnostic value in immunological infertility. The new test correlates better with clinical findings than the sperm-agglutination and sperm-immobilization assays. Compared with the other two tests, it shows a higher percentage of positive reactions with infertile patients. None of the 100 fertile subjects was positive in the Sperm Antibody Slide-Test, as opposed to approx. 13% false positives by the conventional methods. In addition, the new test is easier to perform and requires no vital spermatozoa. Since the kit is stable for over 12 months at 4-8 degrees C, requires no spermatozoal preparations, and has a relatively quick reaction time of 2-5 minutes, it is well suited for the routine diagnosis of patients with immunological infertility problems.

Antibodies↗
PubMed1997

[Application of ultra-short gonadotropin-releasing hormone agonist protocol in controlled ovarian hyperstimulation].

OBJECTIVE: To study the effect of the ultra-short protocol of gonadotropin releasing hormone agonist (GnRH-a) combined with human menopausal gonadotropin (hMG) regimen for ovarian hyperstimulation. METHODS: Setting clomiphene (CC)/human chronic gonadotropin (hCG) (50 cycles, 31 patients) and CC/hmg/hCG regimens (16 cycles, 16 patients who had failed in CC/hCG) as control groups, the ultra-short GnRH-a/hMG/hCG regimen (15 cycles, 15 patients who had failed in CC alone or CC/hMG regimens) as study group, the number of leading follicles, endometrial thickness, cervical mucus scores and hormone levels on the day of hCG administration, and the pregnancy rates were compared among of these three groups. RESULTS: There was no premature luteotropic hormone (LH) surge in the ultra-short GnRH-a/hMG/hCG regimen group while there were three cycles in the CC/hMg/hCG group. The LH and progesterone (P) levels of ultra-short GnRH-a/hMG group on the day of hCG administration were lower than those of CC alone and CC/hMG groups. There were more leading follicles, greater endometrial thickness and cervical mucus score in the ultra-short GnRH-a/hMG group than those in CC alone and CC/hMG groups. The pregnancy rates per cycles in the three groups were similar. CONCLUSION: The ultra-short GnRH-a/hMG regimen is a fairly good ovarian hyperstimulation regimen, especially for poor responders in CC alone or CC/hMG regimens.

Adult↗
PubMed1998

A humanized monoclonal antibody produced in transgenic plants for immunoprotection of the vagina against genital herpes.

The ability to produce monoclonal antibodies (Mabs) in plants offers the opportunity for the development of an inexpensive method of mucosal immunoprotection against sexually transmitted diseases. To investigate the suitability of plant-expressed Mabs for vaginal preventive applications, we compared a humanized anti-herpes simplex virus 2 (HSV-2) Mab expressed in mammalian cell culture with the same antibody expressed in soybean. We found these Mabs to be similar in their stability in human semen and cervical mucus over 24 h, their ability to diffuse in human cervical mucus, and their efficacy for prevention of vaginal HSV-2 infection in the mouse.

Animals↗
PubMed1996

Urinary trypsin inhibitor: a new drug to treat preterm labor: a comparative study with ritodrine.

UNLABELLED: Prevention of preterm delivery is one of the difficult problems facing obstetricians. beta Adrenergic agonists, especially ritodrine, are commonly used in these cases. OBJECTIVES: The aim of this research was to study and compare the effect of urinary trypsin inhibitor (UTI) which has anti-inflammatory anti-cytokine effects with ritodrine in treating preterm labor. STUDY DESIGN: Patients in preterm delivery were randomly selected to be treated either by ritodrine or UTI. In the ritodrine group, uterine contractions were initially suppressed by high doses of ritodrine (up to 300 micrograms/min) and then a maintenance dose was given until 35 weeks of gestation. In the UTI group one vaginal suppository (5000 U) was used daily for 2 weeks. Patients with recurrent preterm uterine contraction during the initial 14 days of treatment, who needed course of other drugs to suppress the contractions, were excluded from the study. Patients responding to the drugs were followed until delivery. Tocolytic index and elastase concentration in the cervical mucus was calculated. Recurrence rate of uterine contraction and time of elongation of pregnancy since the beginning of treatment was calculated. RESULTS: UTI was more effective than ritodrine in inhibition of recurrent uterine contraction and elongation of pregnancy. No side effects could be observed after treatment with UTI for the mother or the fetus. CONCLUSION: UTI may be a new therapeutic method for the inhibition of preterm delivery through suppression of cytokines and inflammatory mediators.

Adrenergic beta-Agonists↗
PubMed1980

["In vitro" glass fiber filtration of sperm (author's transl)].

Filtering sperm through glass fiber has been suggested as a method for improving its fecundity before homologous artificial insemination. Various technical modification of this procedure have enabled good results to be obtained on spermatozoid mobility but at the expense of a marked drop in numbers: sperm counts per ml are diminished by a half. A comparative in vitro study of the penetration of filtered and non-filtered sperm into the cervical mucus showed that glass fiber filtration produced generally no great improvement, and may indeed reduce penetration into the cervical mucus to a marked degree in some cases.

Cervix Mucus↗
PubMed2004

Postcoital testing after the use of a bio-adhesive acid buffering gel (ACIDFORM) and a 2% nonoxynol-9 product.

ACIDFORM is a gel already shown to be safe in vaginal use during six consecutive days through colposcopic observation. A randomized, blinded, crossover study was carried out to compare the spermicidal effect of ACIDFORM to that of a commercial 2% nonoxynol-9 (N-9) product. Twenty sexually active, sterilized women, aged 19-45 years, with regular cycles, normal gynecological exam, no previous sexually transmitted infection (STI) and stable partner willing to undergo four postcoital tests (PCTs) at midcycle during four different menstrual cycles, were enrolled in the study. Known allergy to N-9 or ACIDFORM, oligospermic partner, chronic diseases, use of hormones, previous treatment for STI or presence of STI at screening tests were criteria for exclusion. ACIDFORM or N-9 product administered 0-30 min precoitus or ACIDFORM given 8-10 h precoitus significantly reduced the mean number of progressively motile sperm compared to control cycles (0.19, 0.07, 0.75 vs. 17.94, respectively, p<.05, Wilcoxon test). All treated cycles had five or fewer progressively motile sperm in midcycle cervical mucus, confirming in vivo the spermicidal effect of ACIDFORM previously observed in vitro and in animal models.

Administration, Intravaginal↗
PubMed1994

Evaluation of different sperm function tests as screening methods for male fertilization potential--the value of the sperm migration test.

OBJECTIVE: To assess the value of different sperm function screening tests in predicting fertilization. DESIGN: Prospective study. SETTING: Academic tertiary referral center for fertility treatment. PATIENTS: Ninety-five couples attending for initial screening and IVF-ET. Only cycles where three or more grade I oocytes were collected were included, and patients with endometriosis were excluded. INTERVENTIONS: Each patient had a standard semen analysis, cervical mucus (CM) penetration test, hypo-osmotic swelling test, and sperm migration test performed between 4 and 8 weeks before IVF-ET. MAIN OUTCOME MEASURES: The correlation between sperm function test results and the percentage of fertilized oocytes and the power of the tests to predict fertilization. RESULTS: The sperm migration test correlated highly with fertilization rate (r = 0.62) and was most useful in identifying the group of patients likely to achieve fertilization (Odds ratio [OR] 0.07, confidence interval [CI] 0.02 to 0.2). The CM penetration test showed a moderate correlation with fertilization rate (r = 0.45) and some predictive power (OR 0.37, CI 0.13 to 1.00). Sperm concentration, but not motility or normal morphology, showed slight correlation with fertilization rate (r = 0.28) but the combination of normal semen parameters did not distinguish patients likely to achieve fertilization (OR 1.51, CI 0.62 to 3.65). The hypo-osmotic swelling test did not correlate with fertilization rate (r = 0.21). CONCLUSIONS: This study evaluated the predictive power of several simple tests available for use in most laboratories as screening tests of sperm fertilization potential. Apart from sperm concentration, normal traditional semen characteristics were of little clinical benefit. The hypo-osmotic swelling test had no predictive power. The CM penetration test correlated with fertilization rate but might be difficult to perform routinely as a continuous supply of suitable CM would be required. The sperm migration test proved to be the best discriminator of sperm fertilization potential and should be considered as a first level screening test in the assessment of male fertility.

Cervix Mucus↗
PubMed1988

Self-palpation to assess cervical changes in relation to mucus and temperature.

Women experienced in cervical self-palpation recognize fertile characteristics when the cervix is high, open, soft, and straight; this happens under estrogenic influence. The cervix is said to show infertile signs when it is low, closed, firm, and lying against the vaginal wall; that change occurs quickly under progesterone influence. The objective of this study was to assess the time relationship among changes in the cervix observed by self-palpation, changes in cervical mucus as observed by women, and the shift in basal body temperature during ordinary cycles. A total of 215 symptothermal charts from natural family planning users were analyzed. The duration of the change from the maximum fertility characteristics to the postovulatory return to definite signs of infertility was measured. This duration ranged from 1 to 7 days, with a mean of 2.65. The timing of maximum fertility signs in the mucus was compared with that of maximum fertility signs in the cervix: it varied from 3 days before to 6 days after, with a mean of 0.48 day. The timing of the first high temperature was compared with that of return to definitely infertile characteristics: it varied from 6 days before to 3 days after, with a mean of -0.69 day. Some of the variation may be due to the presence of inexperienced users in the sample. However, a mean difference of half a day between the most fertile cervix and the most fertile mucus on one hand and between the first day of infertile cervix and the first high temperature on the other hand suggest that the cervical changes could be useful indicators of estrogen and progesterone actions.

Adult↗