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PubMed1987

Natural family planning indicators of ovulation.

Indirect evidence of the occurrence of ovulation, which is generally accepted, is an increase in plasma or serum progesterone. Pelvic ultrasonography can estimate the probable time of ovulation within 12 h. There is a close association between the rise in progesterone, luteinizing hormone (LH) and oestrogen peaks and ovulation. A WHO study reported that ovulation occurred at a median time of 8 h after the rise in plasma progesterone, 15 h after the LH peak and 24 h after the oestrogen peak. The basal body temperature (BBT) method is the most effective in determining the premenstrual infertile period, but it is unreliable for an accurate determination of ovulation and the postmenstrual infertile period. Nor is BBT an effective method of predicting ovulation during postpartum lactational amenorrhoea. Therefore, BBT is usually used as a secondary indicator of ovulation and is combined with more reliable indicators. Observed changes in cervical mucus patterns can be used to define the probable fertile period, although this method produces a wide range of days. The peak mucus symptom is closely correlated with ovulation. Mucus symptoms can be used as a guide for the timing of blood or urine samples for estimation of LH, oestrogen and progesterone or their metabolites. Symptothermal methods incorporate other symptoms such as cervical changes, intermenstrual pain, breast tenderness and backaches, but these are secondary signs of ovulation and are recommended to be used in conjunction with mucus and BBT.

Body Temperature↗
PubMed1991

[Chemical contamination of the cervical mucus in cows in relation to pregnancy and age factors].

Applying the method of absorption atom spectrometry (AAS), the contamination of cervical mucus by chemical elements (Cd, Pb, Hg, Cr, Cu, Zn) was demonstrated in the oestrus period of cows in different ecological agricultural regions of the North Moravian region. The results of observation revealed only a statistically significant difference (P less than 0.05) in Cd contents in the test groups; test group mean = 0.015 micrograms.g-1 Cd, control group mean = 0.006 micrograms.g-1. Cr findings in cervical mucus are of priority importance, the same applies to Cu findings. Zinc was found to be an element influencing negatively the conception of cows. The Zn values in cervical mucus of nonpregnant cows were demonstrated to be significantly higher (P less than 0.01) (conception--group = 0.841 micrograms.g-1, conception + group = 0.219 micrograms.g-1 Zn. So called sum of chemical elements: Cd + Pb + Hg + Cr + Cu + Zn was proposed and evaluated as a picture of the total contamination of cervical mucus. This characteristic was also influenced by the Zn findings in the group of pregnant and nonpregnant cows. Zn: Cd antagonism in cervical secretions of barren and pregnant cows was statistically highly significant (P less than 0.01). Chemical elements in cervical mucus were determined for the first time in a digested sample of cervical secretion. The correlation coefficients used for the cows (n = 99) from a contaminated region showed that the content of chemical elements in cervical secretion was not influenced by the age of cows. The content of chemical elements in cervical secretion was not increasing with the age.

Age Factors↗
PubMed2004

A phase I comparative postcoital testing study of three concentrations of C31G.

BACKGROUND: C31G is a broad-spectrum antibacterial agent that shows contraceptive properties in vitro. This postcoital testing study evaluated the ability of three C31G concentrations, 0.5%, 1.0% and 1.7%, administered as a 3.5-mL dose of a vaginal gel to prevent sperm from entering mid-cycle cervical mucus. Irritation of the genitalia and acceptability were also assessed. METHOD: At baseline, a mid-cycle cervical mucus test and a postcoital test were performed within 24 h of each other without use of any study products to establish normal mid-cycle cervical mucus and sperm penetration. Subjects then completed up to three test cycles using one of the three concentrations of study product during intercourse. RESULTS: Twenty-two of the 61 women enrolled completed a baseline cycle and at least one test cycle. An average of 14.6 progressively motile sperm per high power field was seen at baseline. This was reduced to 0.3 after use of 0.5% C31G, 0.5 after use of 1.0% C31G, and 0.4 after use of 1.7% C31G. There was no significant difference between test products (p >/= 1.000) but each test product was significantly different from baseline (p < 0.002). Very little genital irritation was observed. There were more reports of leakage and messiness with increasing C31G concentration. CONCLUSION: This study suggests that all three concentrations of C31G are likely to give reasonable results in a contraceptive effectiveness trial. Based on the results of this and other trials, the 1.0% concentration has been selected for further development, including Phase III trials of contraceptive effectiveness.

Adult↗
PubMed2002

Natural contraception using the Billings ovulation method.

OBJECTIVE: The Billings ovulation method (BOM) is a medical model of a natural procreation education method based on scientific observation of the changes in the cervical mucus. In this study we examined Turkish women's interest in accurate usage of cervical mucus changes in determining the ovulation time. METHOD: Fifteen regularly cycling women monitored their fertility patterns in 30 cycles using the BOM and urine luteinizing hormone (LH) kits. At the end ofeach cycle, the cervical mucus monitoring chart and LH kits were collected from the subjects and analyzed. RESULTS: The cervical mucus symptoms defined a potential fertile period of 10 days' average length, with the 'peak' mucus characteristic occurring at a mean of day 13.65 +/- 2.62 of the cycle. The duration ofthe LH surge, as observed in early morning urine samples, averaged 5 days, with the peak occurring at a mean of day 13.40 +/- 2.58 of the cycle. Data indicated that there was a strong correlation between LH in the urine and the peak in self-observed, cervical-vaginal mucus (p = 0.001). CONCLUSION: This study proved that women can distinguish patterns of ovulation and anovulation by self-detection of variations in cervical mucus characteristics, and that urinary LH levels strongly correlate with ovulation.

Adult↗
PubMed1983

Alternative causes of pelvic inflammatory disease.

Seminal fluid from asymptomatic men reveals a wide variety of aerobic and anaerobic bacteria. The number of bacteria tends to correlate with the sexual experience of the individual. Experimental evidence has shown that these bacteria can attach themselves to moving spermatozoa and travel through ovulatory-phase cervical mucus. Exogenously added bacteria also exhibit the same potential. These experimental results suggest a rational explanation for the development of pelvic inflammatory disease in promiscuous women with multiple sexual partners. In addition, the findings help to explain the marked difference observed in the rate of pelvic inflammatory disease among patients using barrier-type birth control and oral contraceptives as compared with the rate among women who use intrauterine devices, with which the ovulatory-phase cervical mucus is unprotected.

Adolescent↗
PubMed2006

Pharmacokinetics and safety of tanaproget, a nonsteroidal progesterone receptor agonist, in healthy women.

OBJECTIVE: This study aimed to evaluate the pharmacokinetics, pharmacodynamics and safety of the nonsteroidal progesterone receptor agonist, tanaproget. METHODS: A randomized, double-blind, placebo-controlled, sequential-group study of ascending single doses of tanaproget was conducted in healthy, 25- to 45-year-old women on cycle days 8 to 12. Eight subjects (six active, two placebo) per cohort received a dose of 0.1, 0.3, 1, 3, 7 (+/-high-fat meal) or 15 mg. RESULTS: The maximum concentration (C(max)) of tanaproget occurred approximately 2 to 3 h after administration. The elimination half-life (t(1/2)) ranged from 12 to 30 h, and the oral clearance was approximately 70 L/h. The pharmacokinetics of tanaproget was not noticeably altered with a high-fat meal. All doses of tanaproget decreased cervical mucus scores (using a modified Insler method), indicating poor production and poor quality of cervical mucus. The most frequent treatment-emergent adverse events were vaginal bleeding/spotting, abdominal cramping and vomiting; their incidence was not dose related and most events were mild. CONCLUSIONS: Tanaproget was safe and well tolerated, decreased cervical mucus scores and had a pharmacokinetic profile acceptable for use as a once-daily oral contraceptive.

Adult↗
PubMed1989

Recognition of ovulatory/anovulatory cycle pattern in adolescents by mucus self-detection.

The high frequency of anovulation during adolescence raises the question of whether a method for the recognition of ovulation by self-detection of cervical mucus patterns is useful in teenagers. We performed a secondary analysis of 1049 completely recorded cycles of 235 teen women 15-17 years of age with a gynecologic age from less than 1 to 7 years. These subjects had learned to monitor their fertility patterns using the Billings Ovulation Method. The cycles were analyzed by the length of the mucus and luteal phases and recorded "peak symptom." Ovulatory cycles were grouped by the length of the luteal phase, short (4-8 days) and average (8-18 days), and plotted against gynecologic age. The frequency of anovulatory cycles was comparable to Vollman's age-stratified monophasic cycle groups. Ovulatory patterns were found at gynecologic ages of 1 year, 49%; 2 years, 60%; 3 years, 72%; 4 years, 61%; 5 years, 86%; and 6 years, 71%. The study proved that teen-age women can distinguish patterns of ovulation and anovulation by self-detection of cervical mucus.

Adolescent↗
PubMed2000

Evaluation of human spermatozoa in cervical mucus: comparison of different microscopic and extraction techniques.

This study was designed to describe an accurate and consistent microscopic technique for the assessment of sperm number and motility in sperm-cervical mucus samples, such as those of postcoital tests (PCTs), and to identify a suitable method to extract functional spermatozoa from cervical mucus (CM). Sperm-CM preparations containing various sperm concentrations were counted using three different microscopic illuminations. The dark field-Makler technique was compared with the more classical bright field-slide technique currently used by our clinicians. Several sperm extraction techniques were applied first to bovine (BCM) and then to human (HCM) cervical mucus. Dark field microscopic illumination provided accurate, fast, and easy sperm identification. Counting variability was significantly greater with bright field-slide than with dard field-Makler, while sperm motility was always higher with this latter methodology. A high degree of agreement (intraclass correlation coefficient = 0.965) among three raters, i.e., low interobserver variability, was obtained only with dark field-Makler. Extraction procedures based on "swim-out," Percoll, trypsin, an enzyme cocktail, and mercaptoethanol resulted in small sperm yields in BCM. Mercaptoethanol and trypsin also showed poor sperm recovery in HCM. Among the protocols with the largest yields, the mechanical technique had the largest amount of residual CM, and bromelain reduced sperm motility. The extraction with dithiothreitol (DTT) showed the best results with a mean sperm recovery of 76% and enhanced sperm motility. Sperm viability as well as spontaneous and induced acrosome reaction were conserved in all techniques. In conclusion, use of the dark field-Makler counting technique in combination with DTT extraction of spermatozoa from CM samples, such as those of PCTs, would allow accurate and functional assessment of spermatozoa for preliminary contraceptive efficacy or infertility evaluation.

Cervix Mucus↗
PubMed1976

A new method for evaluating cervical penetrability using daily aspirated and stored cervical mucus.

Cervical mucus samples from 33 women undergoing fertility work-up and married to normospermic husbands were aspirated daily with a tuberculin syringe during the periovulatory period. Samples were transferred to polyethylene tubing, sealed, and stored at 4 degrees C for 7 to 14 days. In vitro sperm penetration tests were performed in each case, using only one sample of husband's semen with all of the mucus samples that were collected during one cycle. Preliminary studies with 50 samples of cervical mucus taken at random showed that no difference in physicochemical and penetrability properties existed between fresh mucus and mucus stored for 10 to 14 days. Very often the optimal penetrability of the cervical mucus occurred on unpredictable days. In contrast, many tests performed on days which would have been predetermined for in vivo postocital tests were poor; consequently, those in vivo tests would have been falsely interpreted as negative. This new test using daily aspirated and stored mucus, which is simple to perform, is valuable mainly because it may eliminate the false negative results of other penetration tests. In this way the diagnosis of a truly hostile cervix may be more accurate.

Cervix Mucus↗
PubMed1995

Azithromycin levels in cervical mucus and plasma after a single 1.0g oral dose for chlamydial cervicitis.

OBJECTIVE: To determine the kinetics of azithromycin in cervical mucus and plasma. SUBJECTS AND METHODS: Azithromycin concentrations were determined in plasma and mucus samples from 20 women with cervical chlamydial infection one, seven and fourteen days after a single oral 1.0 g dose. RESULTS: In mucus, all measurable azithromycin concentrations were above the minimal inhibitory concentration against Chlamydia trachomatis on day 7 as well as on day 14. CONCLUSION: The high cervical mucus concentrations of azithromycin can explain the high clinical and microbiological efficacy.

Administration, Oral↗
PubMed1988

Therapeutic donor insemination: the impact of insemination timing with the aid of a urinary luteinizing hormone immunoassay.

The records of 120 patients undergoing therapeutic donor insemination were reviewed to determine if the use of the enzyme immunoassay of urinary luteinizing hormone (LH) to plan inseminations decreased the number of cycles required to achieve conception. All inseminations were performed with fresh semen. Patients in group 1 (n = 26) utilized urinary LH testing in addition to basal body temperature (BBT) and cervical mucus examinations to time their inseminations, while inseminations in group 2 (n = 94) were timed with only BBT and cervical mucus examinations. The monthly fecundability of patients in group 1 was 0.13, whereas the monthly fecundability of patients in group 2 was 0.11. The mean number of inseminations was 1.4 and 1.6 per cycle for groups 1 and 2, respectively. There were no significant differences between groups 1 and 2 in regard to the number of cycles required to achieve conception. The use of a urinary LH immunoassay for insemination timing offers no benefit over conventional methods of timing (BBT, cervical mucus) when fresh donor semen is used.

Adult↗
PubMedDate not supplied

Immuno-bead test (IgG-IgA-IBT) in cervical mucus for the diagnosis of antisperm isoimmunization in female infertile patients with negative or doubtful PCT.

57 infertile women belonging to infertile couples with negative or doubtful PCT underwent the following tests: Sperm Cervical Mucus Contacts Test (SCMC-Test), IgG-IgA-Immuno-Bead Test (IgG-IgA-IBT) in cervical mucus, Micro Sperm Immobilizing Test (Micro-SIT) in cervical mucus and Sperm Immobilizing Test (SIT) in serum. Et least one of the tests gave a positive result in 49.1% of the patients examined and there was a significant difference between the SCMC-Test and the IgG-IgA-IBT: the former was positive in 26 out of 45 patients (57.7%), while the latter was positive in 13 cases (28.8%), (chi 2 = 6.48, p less than 0.05). On the other hand, there was no significant difference between the cervical mucus IgG-IgA-IBT, cervical mucus Micro-SIT and serum SIT; these were positive in respectively 14 (24.5%), 18 (31.5%) and 17 (29.8%) in the 57 patients who underwent all the tests at the same time. Three of the four cases with a mildly positive result of the cervical mucus IgG-IgA-IBT, where the beads were located at the tail-tip, showed negative results to all the other tests performed. Cervical mucus IgG-IgA-IBT is therefore a fairly specific method for the determination of antisperm isoantibodies in the cervical mucus as long as the assessment of those cases with low positivity and beads located mainly at the tail-tip is performed carefully. It is advisable in these patients to take into consideration the results of more classical tests such as cervical mucus Micro-SIT.

Adult↗
PubMedDate not supplied

Enrichment of X-spermatozoa and in vitro penetration through cervical mucus.

Using the Sephadex Gel-filtration method (Steeno - 1975) we carried out a review of the data on the possibility of enriching X-spermatozoa. The testing procedure followed consisted of determining Y-chromatin positive spermatozoa after staining with quinacrine-mustard. We were able to confirm the data recorded by Steeno, according to which an enrichment of about 80-90% can be achieved after penetration through the Sephadex Gel filter. In addition to these investigations we also carried out tests with the enriched X-spermatozoa material to determine in vitro penetration through cervical mucus. No decline in the progressive motility of the spermatozoa was observed. After the Gel-filtration sufficient numbers of these were still able to cover penetration distances of 60 mm/hour. The enrichment effect of the X-spermatozoa declined at the beginning of in vitro penetration, but there was no further change in the subsequent course of penetration.

Cervix Mucus↗
PubMed1998

[The protein profile of the cervical mucus: cyclic and ovulatory values].

Immunological and biochemical analysis on cervical mucus requested application of micromethods on sindle small specimens. The following micro-methods in agar gel are applied: immunoelectrophoresis--the normal cervical mucus developed by antiserum against total human serum is presented with 5 precipitin lines: prealbumin, albumin, a1-antitrypsin, transferrin and IgG. The single immunodiffusion technique in agar gel (Mancini et al., 1964) is suitable method to assess these proteins. The same diffusion method is applied for enzyme assessment with special importance like a-amilase and muraminidase (lysozyme). The assessment of these proteins shows pre-ovulatory decrease and post-ovulatory remarkable increase. These changes are not simply due to the increased water content of the cervical mucus during the fertile period but reflects estrogen effect on cervical secretions.

Cervix Mucus↗
PubMed1993

A field trial of Billings' ovulation method for spacing and limitation of birth.

In spite of constant efforts by health and social workers, existing family planning measures are not used by a vast majority of eligible couples. This is because of the fear that the method may affect their health and happiness. Billings' ovulation method is based on the scientific observation that by noting the changes in cervical mucus, which is clear, slippery and copious in periovulatory period, it is possible to prevent pregnancy by avoiding intercourse during this period. As this method does not require the use of drugs or devices it was decided to promote this method in the urban areas and slums of Patna, Bihar where couples were not using other methods. This is not a comparative study of the cost-effectiveness of Billings' ovulation method versus other contraceptive measures at all. An analysis of 501 cases (267 in urban and 234 in slums) over a period of 2 1/2 years has been presented and it is gratifying to note that the couples from all religions and strata of the society (nearly 47% were slum dwellers) agreed to continue this method.

Adult↗
PubMed1981

Influence of bovine cervical mucus samples and storage conditions on sperm migration in vitro.

In vitro sperm migration assays were performed using bovine spermatozoa and cervical mucus. Experiments were designed to test the effects of storage temperature, method of storage, duration of storage, and source of cervical mucus. Significant variation in migration of spermatozoa was due both to differences in mucus samples and to short-term mucus storage at temperatures ranging from ambient to -196 degrees C. The parallel-orienting effect of cervical mucus on migrating sperm was shown to be a major factor in quantitative assays based upon migration distance. Thus, comparisons of migration among different specimens of semen likely will be biased unless the tests are run simultaneously. Implications of these results are discussed relative to the performance of quantitative sperm migration assays in the clinical or research laboratory.

Animals↗