PubMed · 4018285
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J A Collins, R F Casper, W Wrixon. 1985. Cervical mucus determinations.. https://doi.org/10.1016/s0015-0282(16)48755-8
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During the normal menstrual cycle the volume of cervicovaginal fluid (CVF), as determined by the patient at home using a simple volumetric aspirating pipette, increases significantly over several days prior to the luteinizing hormone (LH) surge and decreases characteristically shortly after ovulation. The present study was undertaken to test the hypothesis that self-determined measurements of CVF volume would correlate positively with serum estradiol (E2) levels and with total follicular volume (TFV) in cycles stimulated with exogenous gonadotropins. Consequently, 20 infertility patients, undergoing human menopausal gonadotropin (hMG)-stimulated cycles, were asked to measure daily CVF. Routine serum E2 determinations and vaginal follicular ultrasound studies were performed up to and including the day of human chorionic gonadotropin (hCG) administration (designated day 0). The mean daily CVF volume (+/- SD) increased from 0.1 +/- 0.01 ml on day -6 to 0.7 +/- 0.40 ml on day -1 and then decreased to 0.6 +/- 0.40 ml on day 0. On day 0, 7 of 20 cycles (35%) demonstrated a decrease in CVF, which ranged from 0.1 to 1.0 ml (mean, 0.42 ml). The mean daily CVF correlated positively (correlation coefficient = r) with the mean daily serum E2 (r = 0.89) and with the mean daily TFV (r = 0.88). The mean daily correlation of TFV for E2 was r = 0.98. The correlation between CVF and E2 of individuals ranged from r = 0.38 to r = 0.99 and the correlation between CVF and TFV ranged from r = 0.12 to r = 1.0, while the individual correlations of E2 to TFV ranged from r = 0.60 to r = 0.99.(ABSTRACT TRUNCATED AT 250 WORDS)
Progestogen-only contraception acts mainly by blocking cervical mucus and preventing sperm penetration through it does have a variable pattern of contraceptive effects on the endometrium and ovary. In contrast with the complete suppression of ovarian function with combined pill or injectable use, a variable degree of endocrine activity is demonstrated in women choosing a long-acting progestogen-only contraceptive. This degree of suppression of ovarian activity explains the decrease in systemic side-effects, the rapid resumption of ovulation and recovery of fertility following the discontinuation of the method. New delivery systems of progestogens, the vaginal ring and implant, offer better and more consistent contraceptive effects.
The rate of diffusion of [125I]-nonoxynol 9 into mid-cycle human cervical mucus was measured and found to be negligible compared with D-glucose (used as an uncharged small molecule for comparison with nonoxynol 9). These data were confirmed by observation of the lack of inhibition of the movement of spermatozoa in mucus that had been in surface contact, for 3 hours, with a concentration 30 times greater than the ED100 of nonoxynol 9. These results show that the entry of nonoxynol 9 into mucus could be minimal under conditions that would exist in vivo and highlights a limitation of this compound as a vaginal contraceptive.