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PubMed1989

A radiolabeled antiglobulin assay to identify human cervical mucus immunoglobulin (Ig) A and IgG antisperm antibodies.

Antisperm immunoglobulin (Ig) A and IgG antibodies in human cervical mucus (CM) were identified by a radiolabeled antiglobulin assay. Cervical mucus samples from fertile and infertile women were exposed to a 1:3,200 dilution of 2-mercaptoethanol (2-ME), and 5 micrograms of the solubilized CM protein were assayed for the presence of IgA and IgG antisperm and anti-Candida activity by the radiolabeled antiglobulin assay. Purified human secretory IgA and IgG exposed to 2-ME retained the molecular integrity and functional activity of the untreated antibody molecules. CM aliquots collected after high-performance liquid chromatography (HPLC) fractionation were assessed for antisperm antibody activity; antisperm antibody activity was retained in the appropriate IgA or IgG CM fractions. The incidence of CM antisperm antibodies was minimally affected when the radiolabeled antiglobulin assay was performed with a motile sperm population. Approximately 70% of the CM IgA antisperm antibodies were of the IgA1 subclass; CM IgG was primarily of the IgG4 subclass. When Candida antigen was substituted for sperm in the radiolabeled antiglobulin assay, the CM antisperm antibodies were found to be exclusively sperm-specific. These data indicate that the radiolabeled antiglobulin assay using 2-ME to extract CM antibodies is a specific method for the assay of antisperm antibodies in CM.

Antibodies↗
PubMed1998

Clinical observation on vertical transmission of human papillomavirus.

OBJECTIVE: To observe the possibility of maternal-fetal vertical transmission of human papillomavirus (HPV) via amniotic fluid. SUBJECTS AND METHODS: Specimens of cervical secretions from 30 pregnant women were obtained during the third trimester before rupture of membrane, and specimens of pharyngeal secretions of their neonates were obtained 12-48 h after birth. Amniotic fluids were collected in 13 pregnant women during cesarean section. The presence of HPV types 6, 11, 16, 18, 31, 33, 35, 38 deoxyribonucleic acid were detected by consensus polymerase chain reaction. RESULTS: HPV deoxyribonucleic acid was found in 16 cervical secretions, 14 pharyngeal secretions and in 3 amniotic fluids, the positive rate was 53.3%, 46.7%, 23.1% respectively. The pharyngeal secretion was also HPV positive in one of the three neonates from the amniotic fluid positive mothers. CONCLUSION: The results indicate that HPV can be transmitted in utero through amniotic fluid and cesarean section can not protect the neonates against vertical transmission completely.

Adult↗
PubMed1975

[Clinical application of synthetic LH-RH for anovular women unresponsive to clomiphene therapy (author's transl)].

UNLABELLED: The purpose of this study is to clarify the significance of synthetic LH-RH (RH) as a therapeutic agent in the treatment of anovular women who fail to respond to clomiphene therapy. METHODS: Fifteen women with hypofunction of the hypothalamus-pituitary system who were given the RH-test were divided into two groups according to the maximum increased level of LH shown by each. Group I consisting of 7 women who showed increased levels of over 20miu/ml received a combination of clomid+estrogen+RH(C.E.R). Blood levels of LH, FSH and estradiol were measured in each. Group II consisting of 8 women who showed maximum levels of LH below 20 miu/ml received RH intramuscularly, 100 mug per day for 20 to 30 days (referred to as RH treatment). The RH-test was performed in this group before treatment, and 1, 7 and 21 days after treatment. Blood levels of estradiol were also determined before, during and after treatment. RESULTS: 1) Ovulation occurred in 5 of the 7 women in group 1 and 3 became pregnant. The LH surge was prolonged and hormonal secretion increased with administration of C.E.R.. The normal estrogen surge and gonadotropin surge occurring in the ovulatory cycle were thus produced artificially. Since administration of clomiphene alone tends to produce insufficiency of cervical mucus secretion because of its anti-estrogen effect, the addition of estrogen to the combination of C.E.R. probably increases the cervical secretion of mucus and enhances the probability of impregnation. 2) Compared to pretreatment levels, RH treatment clearly increased the pituitary secretion of LH and FSH. Even 3 weeks after RH treatment, the pituitary secretion of gonadotropin was definitely higher than before treatment. Fluctuations in blood levels of estradiol during and after treatment were not significantly different than before treatment. These observations would suggest that prolonged administration of RH enhances the gonadotropic function of the pituitary, not only in the secretion of the hormones but also in the synthesis of gonadotropin. Judging from the insignificant effect on the blood level of estradiol, it would appear that RH itself possesses the ability to produce gonadotropin.

Anovulation↗
PubMed2002

The antimicrobial defense mechanism of the female urethra: a reassessment.

PURPOSE: This review of the literature and study of the cytology of the urethra were done to define the potential role of the female urethra as a staging site for urinary tract infection and examine the evidence for a urethral defense mechanism. MATERIALS AND METHODS: We re-analyzed data on the quantitative microbiology of the female urethra published 3 decades ago, reviewed the literature on the initiation of ascending urinary tract infections, the cytology and anatomy of the urethra, and performed studies of the morphology of urethral cells in boys and girls, men, menstruating and menopausal women, and women with acute cystitis. We also considered clues about the urethral microenvironment provided by gonococcal cervicitis and urethritis. RESULTS: We found strong statistical evidence that the female urethra has a powerful antimicrobial defense mechanism, which appears to differ in women with and without recurrent urinary tract infections. We corroborated the findings of previous investigators that the female urethra is lined by cells identical to those of the vagina that respond similarly to estrogens. We found immature basal and parabasal cells in children, and a modest inflammatory response to urinary tract infection. CONCLUSIONS: The female urethra may provide a favorable environment for colonization by uropathogens but it is protected by a powerful defense mechanism. This mechanism may be explained by the shedding of uropathogens bound to exfoliating urethral cells, trapping of bacteria by mucus secreted by the paraurethral glands, intermittent washout by urine, local production of Ig, cytokines and defensins and mobilization of leukocytes.

Adult↗
PubMed1979

Local production of antisperm antibodies in infertile women.

The presence and significance of locally produced antisperm antibody in 20 well-documented infertile patients has been investigated. Sera and vaginal washings both from patients and from fertile controls were examined for antisperm antibody by means of four methods. Antisperm antibody was detected in 25% of the washings taken from infertile patients, but in none of those from fertile women. Detection of antibody by the microimmobilization technique discriminated best between infertile and fertile women both in serum (P=0.0166) and in washings (P=0.0166). The results of this study support the concept that locally produced antisperm antibody contributes to conception failure in a subgroup of infertile women, and that the routine study both of sera and of vaginal washings of infertile patients has practical value.

Adult↗
PubMed2003

Transdermal ethinylestradiol/norelgestromin: a review of its use in hormonal contraception.

UNLABELLED: Ethinylestradiol 20 microg/day plus norelgestromin 150 microg/day have been formulated into a transdermal patch for hormonal contraception. The predominant mechanism of action for transdermal ethinylestradiol/norelgestromin (Ortho Evra, Evra) is inhibition of ovulation by suppression of gonadotropins. It suppresses follicular development, induces changes to the endometrium that reduce the probability of implantation, and increases the viscosity of cervical mucus, which may prevent sperm penetration into the uterus. Two large randomized, nonblind efficacy studies demonstrated that transdermal ethinylestradiol/norelgestromin was as efficacious in preventing pregnancy as oral triphasic ethinylestradiol/levonorgestrel or oral ethinylestradiol/desogestrel. A large, noncomparative study also showed transdermal ethinylestradiol/norelgestromin to have good contraceptive efficacy. Moreover, in the two comparative trials, women using transdermal ethinylestradiol/norelgestromin had higher rates of perfect compliance than women using oral contraception. Age did not affect the rate of perfect compliance in women using the transdermal ethinylestradiol/norelgestromin patch, whereas the rate of compliance reduced with younger age in oral contraceptive users. Pooled results from three efficacy studies found that 1.8% of patches were replaced as a result of complete detachment and 2.9% because of partial detachment. Physical exercise, water immersion, and living in a humid climate did not affect patch adhesion. Transdermal ethinylestradiol/norelgestromin was generally well tolerated in clinical trials. The most common menstrual disturbances were breakthrough bleeding/spotting and dysmenorrhea. The incidence of discontinuation of treatment because of an adverse event was < or = 3.2%, with the most common reason being application-site reactions. CONCLUSIONS: Transdermal ethinylestradiol/norelgestromin offers a well tolerated, effective, reversible, and easy-to-use method of hormonal contraception with an increased likelihood of compliance relative to oral contraceptives.

Administration, Cutaneous↗
PubMed2003

Elevation of interleukin-6 levels in cervical secretions as a predictor of preterm delivery.

BACKGROUND: The objective of this study was to evaluate the predictive value of interleukin-6 (IL-6) in cervical secretions for preterm delivery before 34+0 gestational weeks in patients with preterm labor. METHODS: In this prospective study, 31 patients were enrolled with preterm labor and intact membranes. Cervical swabs were taken on admission and the concentration of IL-6 was measured. The gestational age at the time of admission and delivery, as well as the time interval to delivery, were evaluated and compared with the concentration of IL-6 on admission. RESULTS: Cervical IL-6 was significantly elevated in the preterm delivery group (< 34+0 gestational weeks, p < 0.05). Choosing 20 pg/ml as a cut-off concentration, cervical IL-6 had a sensitivity and negative predictive value of 100%, a specificity of 67% and a positive predictive value of 47%. Concerning the time interval to delivery, the sensitivity of IL-6 was 100% and the specificity 57% for delivery within 2 days and 100% and 64% for delivery within 7 days. CONCLUSIONS: Cervical IL-6 is a new, promising diagnostic tool to identify patients at high risk of preterm delivery.

Cervix Mucus↗
PubMed1992

Breast cancer mucin: an automated assay to detect mucus glycoproteins.

Episialin, a mucus glycoprotein, is a well-known tumor-associated antigen used in a variety of tests to detect the presence of adenocarcinoma. With the introduction of the microparticle-captured enzyme immunoassay (MEIA), a new technique was introduced. We compared this assay with our standard method to detect adenocarcinomas, the measurement of carcinoembryonic antigen (CEA). In breast cancer, the breast cancer mucin (BCM) assay was more often positive in metastatic disease but was not better than CEA in stages I-III. In lung carcinomas, BCM and CEA gave similar results while in colorectal carcinoma, CEA was superior. BCM gave similar results to CA 15.3 in a group of breast cancer patients.

Antigens, Neoplasm↗
PubMed2003

Mucosal immunoglobulin-A and -G responses to oncogenic human papilloma virus capsids.

Oncogenic human papilloma virus (HPV) infection is the most important risk factor for developing cervical cancer. It is known that serum antibody responses against these viruses are associated with persistent infection. We conducted an epidemiological study of 627 women to detect cervical mucosal immunoglobulin (Ig)A and IgG responses to oncogenic HPV capsids. Antibody reactivity and cervical HPV infection genotypes were examined by enzyme-linked immunosorbent assay (ELISA) using HPV types 16, 18, 31, and 45 virus-like particles, and a polymerase chain reaction-based method, respectively. HPV infection was defined as being positive for HPV DNA. Multivariate analysis revealed that a mucosal IgA response was associated with the HPV infection, whereas the IgG response was associated with high-grade cervical squamous intraepithelial lesions (SIL)/squamous cell cancer (SCC) and subject age (40-49 years). IgA was positive in 72% of women with oncogenic HPV infections, whereas IgG was positive in 64% of women with high-grade SIL/SCC. The longitudinal study demonstrated that the IgA response was elicited earlier than the IgG response, and the IgG response was barely induced in the preclinical HPV infection. However, once an IgG response was induced, it persisted longer after HPV clearance. The mucosal IgA response reflects current HPV infection, whereas an IgG response may be induced with the development of cervical lesions.

Adolescent↗
PubMed2000

A new visual indicator of chlamydial cervicitis?

OBJECTIVES: To determine the usefulness of endocervical discharge opacity as a risk indicator for chlamydial infection in relation to two acknowledged visual indicators--yellow endocervical discharge and easily induced mucosal bleeding of the cervix. METHODS: Women from two family planning clinics, a therapeutic abortion clinic, and a university student health clinic (n = 1418 total) consented to a pelvic examination and chlamydia testing, and completed a questionnaire on socio-demographics, sexual behaviour, medical history, and symptoms. A case of chlamydia was defined as positive by culture or blocked enzyme immunoassay in an endocervical swab. RESULTS: The prevalence of chlamydial infection in the clinics was 6.3%. All three of the visual indicators--yellow endocervical discharge, easily induced bleeding, and opaque cervical discharge--were statistically significantly and independently associated with chlamydial infection (odds ratios 2.8, 2.3, and 2.9 respectively), independent of clinic type. Adjustment for the other visual indicators made little difference to the odds ratios. CONCLUSION: Opacity of endocervical discharge was at least as important as the other two commonly acknowledged indicators of chlamydial cervicitis--yellow endocervical discharge and easily induced mucosal bleeding of the cervix.

Adolescent↗
PubMed2001

The relationship between cervical secretions and the daily probabilities of pregnancy: effectiveness of the TwoDay Algorithm.

BACKGROUND: The TwoDay Algorithm is a simple method for identifying the fertile window. It classifies a day as fertile if cervical secretions are present on that day or were present on the day before. This approach may be an effective alternative to the ovulation and symptothermal methods for populations and programmes that find current natural family planning methods difficult to implement. METHODS: We used data on secretions from a large multinational European fecundability study to assess the relationship between the days predicted to be potentially fertile by the TwoDay Algorithm and the day-specific probabilities of pregnancy based on intercourse patterns in 434 conception cycles from the study. RESULTS: The days around ovulation that had the highest fecundability were the days most likely to be classified as fertile by the TwoDay Algorithm. In addition, intercourse on a particular day in the fertile interval was twice as likely to result in a pregnancy if cervical secretions were present on that day or the day before. CONCLUSIONS: The TwoDay Algorithm is effective, both in identifying the fertile days of the cycle and in predicting days within the fertile interval that have a high pregnancy rate. Our data provide the first direct evidence that cervical secretions are associated with higher fecundability within the fertile window.

Algorithms↗
PubMed2005

Establishment of a prediction method for premature rupture of membranes in term pregnancy using active ceruloplasmin in cervicovaginal secretion as a clinical marker.

AIM: Term pregnancy complicated by premature rupture of membranes (PROM) is thought to be associated in part with subclinical infection, and places mothers and neonates at an increased risk for several complications. Therefore, perinatal care would be greatly helped if a reliable clinical measure were available for predicting the incidence of PROM. METHODS: One hundred and ninety-six pregnant women who consented to enter this study were screened using a method developed to assess active ceruloplasmin in cervicovaginal secretion as a clinical marker for predicting the incidence of PROM. Cervicovaginal secretions were obtained from the cervical canal at about 36 weeks of pregnancy. The active ceruloplasmin level in the cervicovaginal secretion was measured using an original enzyme-linked immunoabsorbent assay. RESULTS: Of 196 women, 27 women (13.8%) developed PROM and 169 women (86.2%) did not develop PROM. Active ceruloplasmin in the cervicovaginal secretion was significantly higher in the PROM group than in the non-PROM group (P < 0.001). Analysis using receiver-operating characteristic curves showed that the active ceruloplasmin level (1420.0 ng/mL) proved to be the proper cut-off value to best predict the incidence of PROM. CONCLUSION: Active ceruloplasmin in the cervicovaginal secretion might be a reliable clinical marker for term PROM.

Biomarkers↗
PubMed1993

A neural network to analyze fertility data.

OBJECTIVE: To program an artificial intelligence system, a neural network, and use it to predict results of sperm penetration in bovine cervical mucus (Penetrak assay; Serono Laboratories, Norwell, MA) and zona-free hamster egg penetration from the semen analysis. DESIGN: Results of 139 Penetrak assays, 1,416 zona-free hamster egg penetration assays, and the corresponding semen analyses were retrospectively analyzed by an artificial neural network. MAIN OUTCOME MEASURES: Classification errors of the neural network were compared with those of linear and quadratic discriminant function analyses. RESULTS: Data were separated into training and test sets. For the Penetrak result, linear and quadratic discriminant function analysis correctly predicted 58% and 74% of the training set results and only 64.1% and 69.2% of the test data, respectively. The neural network correctly predicted 92% of training set results and 80% of test set results. For the zona-free hamster egg penetration assay outcome, linear and quadratic discriminant function analysis correctly classified 66.3% and 46.0% of the training set and 64.9% and 44.7% of the test set, respectively. The neural network correctly classified 75.7% of the training data and 67.8% of the test data. CONCLUSIONS: Using the semen analysis, the neural network correctly classified 67.8% of zona-free hamster egg penetration assay results and 80% of Penetrak results it had not encountered previously, suggesting that this method of data analysis may be successfully employed to predict fertility potential.

Animals↗
PubMed1991

Decidual transformation of human extrauterine mesenchymal cells is associated with the appearance of insulin-like growth factor-binding protein-1.

Human extrauterine decidual cells were studied for the presence of insulin-like growth factor-binding protein-1 (IGFBP-1) by using an avidin-biotin complex immunoperoxidase method with a purified monoclonal antibody 6303 against IGFBP-1. It is well established that human decidua expresses mRNA for IGFBP-1 and synthesizes and secretes this protein. We now describe, for the first time, that cells morphologically similar to uterine decidual cells found beneath the peritoneal mesothelium in inguinal hernia and in the cervical mucosa during normal pregnancy and in the mesenchymal tissue of the Fallopian tubes and ovaries at term react with the monoclonal antibody for IGFBP-1 equally to endometrial decidual cells. These results imply that the extrauterine mesenchymal cells, which have undergone decidual transformation, are not only morphologically but also functionally, similar to their counterparts in the uterus. Secondly, the data suggest that IGFBP-1 expression is associated with a special type(s) of cells and a certain stage of differentiation rather than special organs in the body.

Carrier Proteins↗
PubMed2003

Long-term results in patients after rectosigmoid vaginoplasty.

Many methods are used for vaginoplasty, including the split-thickness skin graft, full-thickness skin graft, and inverted penile skin flap. However, these procedures are not entirely satisfactory in cases of reconstructed vaginal stenosis, inadequate vaginal length, or poor lubrication. The small intestine, ascending colon, and sigmoid colon can be used in the intestinal flap method, and the authors modified the operation first described by Baldwin in which a loop of rectosigmoid is isolated, closed at one end, and brought down on its vascular pedicle as a neovagina and then anastomosed to the perineum. Vaginoplasty using the rectosigmoid was performed in 36 patients (28 male-to-female transsexual patients, five patients with congenital vaginal atresia, and three with cervical cancer). The follow-up period ranged from 1 to 10 years. The postoperative results were analyzed through physical examination and interview regarding the patient's functional status and satisfaction during sexual intercourse. The mean depth and width of the vaginal cavity were 12.5 cm and 3.9 cm, respectively. Excessive mucosal discharge was seen in 8.3 percent, and malodor was found in 8.3 percent. All patients who had partners were able to have sexual intercourse; 2.8 percent of patients used lubricants and 5.6 percent used dilators before intercourse for more than a year postoperatively. During intercourse, 88.9 percent of the patients experienced orgasm. The cosmetic and functional results of rectosigmoid vaginoplasty were excellent. Thus, the advantages of rectosigmoid vaginoplasty are (1) rare contraction of the reconstructed vagina, (2) vaginal width and depth maintained without long-term vaginal stent, (3) spontaneous mucus production facilitating sexual intercourse, (4) avoidance of the malodor frequently accompanying skin graft, and (5) texture and appearance similar to that of the natural vagina. The authors concluded that rectosigmoid vaginoplasty is the best choice for transsexual patients who have previously undergone penectomy and orchiectomy, patients with unfavorable previous vaginoplasty, those with short vaginal length after cervical cancer surgery, and patients with congenital vaginal atresia.

Adult↗
PubMed1987

Penetration ability of human spermatozoa into standardized bovine cervical mucus (Penetrak) in patients with normal and pathological semen samples.

Semen samples from 89 men were analyzed and evaluated with a standardized bovine cervical mucus penetration test (Penetrak). 29 patients had a normozoospermia, 22 patients a teratozoospermia and 38 patients an oligozoospermia of various degree. The most important parameters of semen analysis were compared with sperm mucus penetration. The sperm mucus penetration test correlated best with progressive motility (r = 0.6758), followed by total motility (r = 0.6302), sperm count (r = 0.6190), and % normal spermatozoa (r = 0.5493) (p less than 0.01 for each correlation coefficient). In the group of patients with normozoospermia 6 cases had been detected with insufficient sperm mucus penetration and in both groups with subfertility 15 cases with adequate sperm mucus penetration. 8 semen samples with normal sperm count and normal sperm motility were used for IVF. Only 6 patients with normal sperm penetration (greater than 30 mm/90') the spermatozoa fertilized the ova, but not from two patients, who had a sperm mucus penetration of less than 30 mm/90'. The study demonstrated that standardized bovine mucus penetration test detects disturbances of sperm motility which may not be discovered by conventional semen analysis.

Adult↗
PubMed1983

[Release of copper ions after insertion of VCu200 IUDs].

In order to understand the life span of VCu200 IUDs in situ, the copper-ion concentrations in the cervical mucus were assayed after insertion of VCu200 IUDs for 5 years. Copper-ion concentrations were measured at random in 30 cases each of 1, 3, 6, and 12 monthth VCu 200 IUD users and 20 cases each of 24, 36, 48, and 60 month users. At the same time, 10 cases of the inserted-ring users were similarly studied for comparison. In addition, to obtain the normal copper-ion concentrations in the cervical mucus during the proliferative phase (8th-9th day), mid-period phase (10th-14th day) and the secretory phase (20th-23rd day) of a norma cycle, 16 cases of nonusers were selected as control. The measurements were assayed by a non-flame atomic absorption spectrophotometer. Samples of 0.2-0.4 gms of cervical mucus were collected in a glass tube from the IUD users on the 20th-23rd day of the menstrual period. There is a significant difference between VCu200 IUD users and nonusers (p 0.01) and ring users (p 0.01). The copper-ions released in VCu200 IUD users in different months were 2.61, 1.98, 1.96, 1.82, 1.22, 1.20, 1.15, 0.98 ug/g. w. w., respectively. The equation for regression line is y = -0.2764x+2.2340, which shows that the amount released decreased wtih increased time interval. However, the released amount of copper-ions at the end of 60 months was still higher in the users than in the nonusers (p 0.05). These results indicate that VCu200 IUDs can be left in situ at least 5 years without decreasing its biological activity in contraception.

Chemical Phenomena↗
PubMed1975

Quantitative analysis of immunoglobulins and albumin in secretion of female reproductive tract.

Total protein, IgG, secretory IgA (SIgA), IgA, IgM, and albumin were quantitatively analyzed in 115 cervical fluid specimens from healthy, adult women. Although albumin was the most predominant protein among those that were analyzed (17.2% of total protein), IgG was the major immunoglobulin in this secretion (8.7%). A highly significant correlation between the levels of IgG and albumin and a mean IgG-albumin ratio similar to that of serum suggest that both proteins originate from the circulation. Although the main type of IgA was of the secretory type (4.4%), serum type IgA (smaller than 1.0%) was close to 2. The mean levels of IgG and albumin (but not of SIgA) of the postpartum group were significantly higher than those of the normal subjects. The number of children, the current method of contraception, and present and past local infections had no effect on the immunoglobulins and albumin in this secretion when the mean levels of these components were analyzed and compared with the "normal" values.

Adolescent↗