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Human cervical mucus. II. Changes in viscoelasticity during the ovulatory menstrual cycle.

Quantitative viscoelasticity measurements were made on individual human cervical mucus samples by microrheometry. Increases in mean values for mucus spinnbarkeit, ferning, and wet weight were associated with the ovulatory phase of the menstrual cycle, while no significant differences versus time were noted for mean values for sample pH or nondialyzable dry weight. A nadir in mucus nondialyzable solids (NDS) concentration and in visoelasticity was seen at or near midcycle. Substantial, highly reproducible, variations in mucus viscoelasticity were observed when mucus from different donors was compared. When the contribution of (NDS) to viscoelasticity was minimized by data normalization or by sample reconstitution, a significant increase in viscoelasticity was associated with the ovulatory phase of the cycle, suggesting the occurrence of a relative increase in mucin concentration or a compositional change in the mucus.

Cervix Mucus↗

Human cervical mucus. III. Isolation and characterization of rheologically active mucin.

Several common mucolytic agents were screened for their ability to solubilize cervical mucus without incurring irreversible losses in mucus viscoelasticity. Sodium thiocyanate was selected on the basis of its effectiveness and handling convenience, and solubilized mucus was fractionated by gel filtration on Sepharose columns. The excluded mucin fraction was characterized by a high neutral hexose to protein ratio and contained all of the elasticity of thiocyanate-treated whole mucus. The concentration of mucin in individual mucus samples collected throughout the ovulatory menstrual cycle was determined from column elution profiles. An increased relative amount of mucin was associated with samples collected during the ovulatory phase of the cycle, and a strong correlation was obtained when the percentage of mucin in individual samples was plotted against their respective storage moduli. These results indicate that the cyclic fluctuations in mucus viscoelasticity seen previously at constant concentrations of nondialyzable solids can be attributed to variations in mucin concentration. Evidence was also obtained, however, for compositional differences in mucus derived from different patients.

Cervix Mucus↗

Human cervical mucus. IV. Viscoelasticity and sperm penetrability during the ovulatory menstrual cycle.

Quantitative viscoelastic and sperm penetration measurements were made on individual human cervial mucus samples collected from several ovulatory menstrual cycles. An inverse relationship was found to exist between these two mucus properties, with peak penetrability seen during the ovulatory phase of the cycle when viscoelasticity was lowest. Limited sperm penetration was also observed with follicular phase mucus. When mucus was collected three times daily, the first sample of the day showed reduced pH values and elevated percentage of nondialyzable solids (NDS) and viscoelastcity. Rates of mucus production were calculated for two cycles; the highest rate was seen during the ovulatory phase, with the follicular and luteal phases showing approximately 50% and 30% of this rate, respectively. Limited disparities were noted between midcycle changes in percentage of mucus NDS and viscoelasticity and in blood levels of total estrogens.

Cervix Mucus↗

Interobserver variation in estimation of day of conception intercourse using selected natural family planning charts.

In order to study outcome of pregnancy related to timing of conception it is necessary to have both markers of ovulation and records of intercourse. Natural family planning (NFP) charts where the woman records basal body temperature (BBT) and mucus signs are ideal for this purpose. Much work has been done relating timing of BBT and mucus signs to ovulation, but very little work has been done to examine interobserver agreement on the interpretation of these signs. Four NFP experts examined 28 NFP pregnancy charts to determine the BBT rise, the mucus peak, and two most likely days of conception intercourse. The charts were selected because they provided difficulties in interpretation. The reviewers were able to agree on the most probable day of conception intercourse in 96.4% of cases, on the mucus peak in 74.1% of cases, and on the interval between the most probable conception intercourse and mucus peak in 70.4% of cases. There was poor agreement on the first day of the BBT rise (38.5%). The authors conclude that in selected difficult NFP charts, the mucus peak is a more valid indirect measure of ovulation both because it is subject to less interobserver variation and because it more closely approximates the timing of ovulation.

Body Temperature↗

Isolation of AIDS-associated retrovirus from genital secretions of women with antibodies to the virus.

The AIDS-associated retrovirus (ARV) was isolated from vaginal and/or cervical secretions from 4 out of 8 women whose sera contained antibodies to the virus. The quantity of virus recovered initially was so low that identification of ARV was accomplished only after passage of the isolates to cultured mitogen-stimulated normal human peripheral blood mononuclear cells. The results indicate that the vaginal canal under certain conditions could be a source of transmission of ARV.

Acquired Immunodeficiency Syndrome↗

Carbonic anhydrase activity in human cervical mucus and its response to various contraceptives regimes.

Carbonic anhydrase activity is present in human cervical mucus throughout the normal menstrual cycle. Lowest activity occurs in the ovulatory phase. A similar pattern of activity is seen in the presence of either an 'inert' or copper-releasing intrauterine contraceptive device (IUCD). The overall levels of activity are not significantly altered by the presence of either type of IUCD. A cyclic pattern of activity is retained even though endogenous ovarian function is suppressed by combined oestrogen-progestogen oral contraceptives.

Carbonic Anhydrases↗

Cervical mucus and prediction of the time of ovulation.

12 normal ovulatory women were studied during 17 menstrual cycles. The first day on which the women had increasing quantities of 0.1 ml or more clear cervical mucus (IQCCM) was closely related to the time of ovulation as monitored by basal body temperature and radioimmunoassay of serum-luteinizing hormone, follicle-stimulating hormone, estradiol, and progesterone. The results show that the time of ovulation can be predicted clinically without specialized tests by observing the day of onset of IQCCM.

Adult↗

Antibacterial activity of human cervical mucus.

The antimicrobial property of human uterine cervical mucus was tested in three groups of women. Healthy women, using no contraception, women using an intrauterine device and women receiving hormonal treatment for contraception. Cervical mucus was taken on the 10th, 14th, 18th and 22nd day of the menstrual cycle. Cervical mucus had a strong inhibitory effect on the growth of Micrococcus lysodeicticus in all three groups. The strength of the inhibitory effect on the other microorganisms were in the following order: Staphylococcus albus, Staphylococcus aureus, Proteus mirabilis, Escherichia coli, Candida albicans, Streptococcus haemolyticus, Streptococcus faecalis. Use of an intrauterine device did not affect the antimicrobial effect of cervical mucus. The use of hormonal contraceptive canceled the antimicrobial effect on the series of microorganisms, with the exception of M. lysodeicticus. The maximum inhibitory effect occurred on the 14th day and declined toward the end of the menstrual cycle.

Adult↗

A study of peroxidase levels in human cervical mucus as an index of ovulation.

Fourteen healthy women were screened for the following parameters throughout one complete menstrual cycle: levels of urinary oestrogens and pregnanediol; levels of plasma and urinary gonadotrophins; and pH, protein content and levels of peroxidase in the cervical mucus. It was found that concentrations of peroxidase in the cervical mucus were not a reliable index of ovulation.

Cervix Mucus↗

Efficacy and clinical profile of a new oral contraceptive containing norgestimate. U.S. clinical trials.

The search for a highly selective progestin that exerts a potent and targeted progestational response with minimal or absent androgenic effect has paralleled investigation into the possible impact of these agents on cardiovascular disease in women. Such a progestin, norgestimate (NGM), in a dose of 250 micrograms, has been combined with ethinyl estradiol (EE) 35 micrograms in a new oral contraceptive (OC), Ortho-Cyclen or Cilest. Results of two long-term, multicentric clinical trials demonstrate that this formulation is comparable in efficacy to the norgestrel-containing OC Lo/Ovral. There were no statistically significant differences in pregnancy rate, and both OCs were well-tolerated in a large and diverse study population. In several areas, however, the inherently lower androgenicity of the norgestimate OC produced clinical changes compared with the norgestrel formulation. These changes were primarily evident in the more natural menstrual patterns with the norgestimate OC, its less severe impact on the endometrium, and, most important, its positive impact on lipoprotein metabolism. NGM/EE consistently produced statistically significant increases in high density lipoprotein (HDL) and concomitant improvement in the ratio of low density lipoprotein (LDL) to HDL. By cycle 24, this highly predictive parameter of atherosclerotic risk had decreased 7.7% in the NGM/EE group. Conversely, the norgestrel-containing formulation resulted in statistically significant decreases in HDL and increases in the LDL/HDL ratio; by cycle 24, these patients showed an 18.5% increase in the LDL/HDL ratio. All between regimen comparisons of mean changes in the LDL/HDL ratio were statistically significant, from baseline through cycles 3, 6, 12 and 24.

Adolescent↗

Detection of estrus in dairy cows by electrical measurements of vaginal mucus and by milk progesterone.

Electrical resistance (ohms) of mucus were analyzed in 20 postpartum Holstein cows by use of a probe inserted into the anterior vagina every other day for 30 days. Composite milk samples were taken on the same day, and progesterone was determined by radioimmunoassay. Cows were observed twice daily for standing estrus and reproductive organs palpated weekly per rectum (rectal palpation). Fifteen cows which were cycling showed increasing progesterone 6 to 7 days after the onset of estrus with values of 8.1 to 10.0 ng progesterone/ml milk on days 10 to 17. Concentrations had declined rapidly 2 days before onset of the next estrus. Progesterone in milk was affected by cow and by day of the cycle. Electrical resistance followed a similar cyclical pattern, but variability was large and only cows differed. The correlation between milk progesterone and mucus resistance was .22. Progesterone concentrations for four cows with follicular cysts fluctuated randomly with a mean of 2.6 ng/ml. Mean resistance of vaginal mucus was 44 omega for both cycling and cystic cows, indicating that a single measurement of electrical resistance every 2nd day was unreliable in distinguishing physiological states. One cow had high progesterone in milk on days 19 to 25 and was diagnosed pregnant by rectal palpation 3 wk later. Cows were not seen in estrus 28% of the time when milk progesterone and rectal palpation indicated they were in the follicular phase of the estrous cycle and were cycling.

Animals↗

Antibodies to spermatozoa. VII humoral and cellular aspects of sperm inmunity and infertility.

The occurrence of sperm antibody in serum and cervical mucus of women from intertile couples in the serum of their male partners, as well as cellular immunity to sperm, has been studied by agglutination and immobilization techniques. For a total of about 260 couples, the tests on serum showed that 18% of the women and 8% of the men were positive by the Kibrick technique and that 15% of the women and 4% of the men were positive by the F-D technique. The women who were positive in their cervical mucus were 8% of the group by the K-agg (Kibrick agglutination) technique, 2% by the MIS-agg. (Microscale agglutination) technique, and 40% by the MIS-imm. (Microscale immobilization) tecnique. In considering all three techniques. 42% of a group of 132 women were positive. Cellular immunity to sperm, by the Migration Inhibition method, was positive in 18% and zero per cent of infertile and fertile women, respectively.

Antibody Formation↗

Postcoital test abnormalities in relation to contraceptive use.

Abnormalities of cervical mucus can have a bearing on a woman's fertility. One means of detecting the presence of such abnormalities is the postcoital test (PCT). As part of a population-based case control study of risk factors for infertility, the reproductive, contraceptive, medical, and sexual histories of women seeking treatment for infertility who had abnormal PCT results were compared with those of fertile controls. A greater proportion of infertile women with an abnormal PCT had previously used a diaphragm than had control women (relative risk (RR) = 3.5, 95% CI = 1.1-11.3). The excess risk associated with use of a diaphragm was particularly high for women who had used one for longer than one year (RR = 7.3, 95% CI = 1.4-37.8), or within one year of attempting to conceive (RR = 5.5, 95% CT = 1.4-22.1). No increased risk was associated with the use of other barrier methods, oral contraceptives, or the intrauterine device.

Adult↗