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PubMed1988

The temporal relationship between vaginal fluid volumes obtained with the Rovumeter vaginal aspirator and the fertile phase of the cycle.

Recent trends in family planning demonstrate an increasing interest in natural methods of birth regulation. In their present form, however, these methods are highly subjective and individualistic. A further trend in fertility programmes has been a very rapid development of technological methods to detect fertility in the female cycle, some of which could possibly benefit natural family planning users. One such technique--that of changing volumes of cervico-vaginal fluid (CVF), which is a mixture of cervical mucus and vaginal transudate--has been tested in a pilot study to ascertain its reliability to demarcate the fertile phase of the cycle. Results show that in all cycles tested, it is possible using the Rovumeter aspirator to detect the beginning of the fertile phase by rapidly increasing volumes of CVF; this volume reaches a peak approximately 1 day before ovulation detected by ultrasound and demonstrates an abrupt fall after ovulation and the onset of the infertile phase. From the results of this pilot study, we believe that, by the use of suitable algorithms and larger studies, it should be possible to develop a CVF volume method which could be offered as an objective alternative method for users of natural family planning and programmes.

Adult↗
PubMedDate not supplied

Semen parameters in Norwegian fertile men.

The World Health Organization (WHO) provides guidelines for assessing the various semen variables. A set of reference ranges is given in the WHO Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction, but several studies indicate that the values should be revised. Furthermore, semen parameters obtained at different laboratories are not directly comparable even if the same methods are used. Thus, it is recommended that each laboratory establish its own reference ranges. In this study, semen from 99 men who had recently achieved a pregnancy were analyzed to establish reference ranges for semen variables. The reference values were based on the group with time to pregnancy (TTP) 12 cycles or less (92%) and abstinence time from 2 to 7 days. The 5th and 10th percentiles for sperm concentration were 10.6 and 16.9 x 10(6)/mL, respectively, and 33% (5th percentile) and 43% (10th percentile) for spermatozoa with progressive motility. These values were below the WHO lower limit. The percentages of ideal spermatozoa (percentage with normal morphology according to WHO strict criteria) were 3 (5th percentile) and 4 (10th percentile). Thirty-nine percent reported that their partners became pregnant during the first cycle after they had stopped using contraception. The semen parameters in this group were compared with the others. Overall, the semen parameters were more favorable in the group with TTP = 1 cycle than in the group with TTP > 1. Sperm concentration, progressive motility, and percentage of ideal spermatozoa according to WHO strict criteria were significantly different in the 2 groups. However, when analyzed by multiple logistic regression, only "total numbers of sperm with progressive motility" remained in the model (P = .002). This is in accordance with previous studies indicating that a combination of semen characteristics provides a better predictor of male fertility potential than the single parameters. In conclusion, new reference ranges for semen variables deviating from the WHO values are established for our laboratory.

Adult↗
PubMed1978

The "unexplained" poor postcoital test.

In 30 or 32 infertile couples with an unexplained negative or bad in vivo and in vitro sperm penetration test, we obtained a strongly positive Sperm Cervical Mucus Contact test (SCMC-test) and demonstrated the presence of antisperm antibodies in the male or female partner. In these 30 couples 25 of the male partners had a sperm-agglutination titre of at least 32 in the serum and at least 4 in the seminal plasma. In the five remaining couples the female partner showed a minimum sperm-agglutination titre of 16 in the serum and a cervical mucus titre of at least 128. In 48 couples with a fair or good sperm penetration in cervical mucus, in vivo and in vitro, we never found a strongly positive SCMC-test. In 43 of these couples the SCMC-test was negative. Only one man in the latter group had sperm-agglutinating activity in the semen. In a group 32 couples, with a negative SCMC-test, there was no or only weak sperm-agglutinating activity in the cervical mucus, although 2 women had moderate sperm-agglutinating activity in the blood serum. Based on these data we conclude that the so called "unexplained" poor postcoital test is almost always due to the presence of antisperm antibodies in the semen or in the cervical mucus. We consider the SCMC-test not only to be a simple and reliable technique for detecting the presence of these antisperm antibodies, but also a method of demonstrating the mechanism by which antisperm antibodies decrease the chance of conception.

Antibodies↗
PubMed1989

Long-acting steroidal contraception: an update.

Long-acting, injectable contraceptives first became available in the 1960s. It is currently estimated that almost 3.5 million women are now using depo-medroxyprogesterone acetate (DMPA); 800,000 are using norethindrone enanthate (NET-EN), and another few hundred thousand are using a variety of once-a-month injectables comprised of progestin plus estrogen. The advantages of injectable contraceptives are that they are highly effective, independent of coitus, easily administered, and they ensure regular contact with health services personnel. The last factor may be considered a disadvantage by some, since contact is more frequent than would be required for routine health services. The major disadvantage of the progestin-only formulations is disruption of normal menses, giving rise to unpredicted episodes of bleeding and spotting. With the once-a-month formulation, on the other hand, there are few discontinuations due to disruption of menses. For a long-acting method to be used longer than 6 months, it is desirable to choose an implant, since the method can be discontinued at will. The first implant system to be developed was Norplant, a set of six rubber capsules filled with levonorgestrel and implanted under the skin. The implant releases sufficient levels of medication to protect against pregnancy. For the first 5 years, the average failure rate was four or five per thousand users per year. The failure rate for women using standard oral contraceptives is approximately 20 to 50 per thousand. The most common side effect of the implant method is the disruption of the menstrual cycle, an effect that is particularly marked in the first month of use.(ABSTRACT TRUNCATED AT 250 WORDS)

Contraception↗
PubMed1980

Experimental study of cervical blockage induced by continuous low-dose oral progestogens.

An investigation correlating scanning electron microscopic observations with sperm penetration tests carried out on cervical mucus under the influence of low-dose continuous progestogen (Norgestrienone) is presented. The results demonstrate that such type of contraceptive is involved in drastic alterations of mid-cycle cervical mucus at the macromolecular level. The meshwork which constitutes the infrastructure of the cervical secretion appears to be greatly tightened as a result of the treatment, thus giving the woof a general appearance typical of cervical mucus in the late luteal phase. The immobilizing effect of such modified mucus on spermatozoa is demonstrated and the duration of effectiveness after the administration of a last pill on the morning of day 13 is determined.

Administration, Oral↗
PubMed1991

Effects of various IUDs on the composition of cervical mucus.

The influence of three different intrauterine devices on the composition of cervical mucus was studied. The amount of mucin, albumin and immunoglobulin G was estimated. After the insertion of an inert IUD, a decrease in mucin was observed. During copper-IUD use the content of mucin, albumin and IgG was increased in cervical mucus, while weight was not affected. In the levonorgestrel-IUD users, ovulation was inhibited in 2 out of 8 women. Mucus weight was increased. The amounts of mucin, albumin and IgG were not changed. In an in vitro experiment the effect of copper-IUDs on autooxidation of cholesterol was studied. There was an extensive conversion of cholesterol but addition of albumin quenched the oxidation of cholesterol. It is suggested that the increased secretion of albumin induced by copper-IUD users may offer protection against copper-induced cell damage.

Body Weight↗
PubMed1991

Human cervical mucus: research update.

Evaluation of cervical mucus is a standard for determining the fertile period in natural family planning. Cervical mucus accepts, filters, prepares, and releases sperm for successful transport to the egg and fertilization. Recent scientific advances provide answers to how the mucus regulates fertility as its physical properties change during the menstrual cycle. Transmission electron microscopy reveals small interstices between mucus macromolecules relative to a sperm head. Thus advancing sperm must push aside or cut through the microstructure. The interstices are largest in the periovulatory phase of the cycle. Small magnetic spheres, comparable with the size of a sperm head, are now being used to study the physical properties of the mucus on the scale of individual sperm.

Cervix Mucus↗
PubMedDate not supplied

Postcoital test: which form of spermatozoal motility is associated with a good fertility outcome?

The objectives of this study were to examine the predictive value of the PCT in relation to treatment-independent conception rates, to determine which cutoff point best predicted fertility outcome, and which form of spermatozoal motility on PCT is most significantly related to fertility outcome. A prospective study was undertaken of couples referred for the investigation of "unexplained" infertility. One hundred and twenty six couples were recruited between July 1984 and April 1986. On further investigation female infertility factors were identified in 32 (25%) of couples, who were therefore excluded from the study. All conceptions were treatment independent. The relationship between the result of the postcoital test and the chance of conception was studied using a modification of Cox's regression model of life table analysis. The mean length of involuntary infertility prior to referral was 75 months (range = 18-192, SD = 39.2). The mean length of follow-up was 18 months (range = 1-34, SD = 8.4). A 98% follow-up rate was achieved. Eighteen women conceived, giving a 32-month treatment-independent conception rate of 22%. A cutoff point of one spermatozoon exhibiting sluggish motility per HPF was the most effective method of classifying the results of the postcoital test (X2(1) = 4.28, P = 0.037, RR = 4.7. This would suggest that the most efficient form of spermatozoal motion in cervical mucus is slow or sluggish motility.

Adult↗
PubMed1981

[The efficacy of gestoden (delta 15-d-norgestrel) as ovulation inhibitor (author's transl)].

Two single-phase combined low-dosage oral contraceptive preparations were tested with respect to their effects on functional parameters of the menstrual cycle. Twenty young women with a normal biphasic menstrual cycle took part in this random study. Evaluation of cervical function, consistency and crystallisation ability of the cervical mucous and of the karyopyknosis index as well as radioimmunoassay of the serum levels of LH, FSH, HPRL, 17-beta-oestradiol and progesterone were carried out consecutively as from the 8th day over the duration of one control cycle and one in which contraceptive as administered. Preparation I (SH D 356 A) contained 75 micrograms delta 15-d-norgestrel (Gestoden) + 30 micrograms ethinyloestradiol. Whilst preparation II (SH D 356 B) contained 75 micrograms d-norgestrel + 30 micrograms ethinyloestradiol. Both substances successfully inhibited ovulation, whereby the former achieved a markedly greater suppression of function with regard to all parameters and, yet good menstrual cycle control was maintained. Hence, gestoden enables the content of active components in oral contraceptives to be reduced even further without detracting from the safety of the technique.

Adult↗
PubMed2003

Radioactivity in cervical mucus after intraperitoneal deposition of Tc-99m labelled albumin particles before and after sterilisation.

OBJECTIVE: To study the transport of radiolabelled albumin particles from the pouch of Douglas to cervical mucus. STUDY DESIGN: A prospective randomised study, including 10 healthy women, undergoing laparoscopic sterilization. A solution of human serum albumin particles, labelled with Technetium 99(m) (Tc-99(m)) was injected into the pouch of Douglas, either before or after sterilisation. RESULTS: Gamma camera images showed gradual spread to the entire peritoneal cavity. Blood samples, showed increasing levels of radioactivity. Measurement of radioactivity in cervical mucus showed significant activity both in women sterilized before and after the deposition. CONCLUSION: The study showed evidence of transport of radioactivity from the pouch of Douglas to cervical mucus. The transport seemed to consist of free activity since no radionuclide labelled particles could be detected in cervical mucus. The transport was probably haematogenous or lymphatic and not intraluminal through the fallopian tube. Further studies utilizing particles comparable in size to fertilized ova are required to design methods for evaluating the transport from the fallopian tube to the uterine cavity.

Adult↗
PubMedDate not supplied

[Pro clomiphene].

Thanks to CC an important number of endocrine sterility has been cured. The antiestrogenic effect of CC has been accused to promote perturbations of cervical mucus secretion and endometrial receptivity. The different technics to assure correction of negative side effects while promoting optimal activity of clomiphene will be discussed in terms of modern evaluation methods.

Abnormalities, Drug-Induced↗
PubMed1982

The effect of estrogen and gestagen on the mucus production of human endocervical cells: a histochemical study.

The effect of hormonal stimulation on the intracellular mucus production of the endocervical cells was histochemically and morphometrically investigated. Twenty-seven cervixes from patients who had received estrogen or gestagen prior to hysterectomy were examined. "Upper" versus "lower" cervix and "small" versus "large" crypts were compared in both groups of patients. The histochemical analysis of mucins within the cells was based mainly on the combined alcian blue/periodic acid Schiff (AB/PAS) techniques at various pH levels. A semiquantitative estimation using cell counts and statistical evaluations was done for each staining method. The results indicate that sex hormones influence the chemical composition of endocervical mucus production. In addition, the nature of the intracellular mucus varies with the cryptal size and location within the cervical canal.

Alcian Blue↗
PubMed1983

Estrous intensity and conception rates in Holsteins.

During 34 mo, 732 inseminations were evaluated in Holstein cows and heifers of breeding age. Females were submitted for insemination after detection of either 1) standing estrus, 2) mounting activity, or 3) other subtle symptoms of estrus (clear mucus, general appearance of genitalia or tailhead, and excessive vocalization). Conception rates were similar following standing estrus and mounting activity (50 versus 46%). Although higher conception rates occurred following standing or mounting activity than after detection of subtle estrous symptoms, one of three inseminations resulted in conception after insemination in the latter group. Clear mucus in half of the females upon cervical manipulation at insemination was associated with higher conception. Service number, age, and maximum ambient temperature on day of insemination also affected conception rates. Methods of thawing semen, ease of cervix penetration at insemination, service sire, inseminator, and time of estrous detection and insemination had little effect on fertility. Acceptable conception rates were achieved with more liberal interpretation of estrous symptoms.

Age Factors↗
PubMed1989

Structural changes in human cervical mucus.

The crystallization phenomenon of human cervical mucus was investigated with the help of scanning electron microscope. Changes in the conformation of crystals and ferning patterns were studied on different days of the menstrual cycle in both normally ovulating women and those using oral contraceptives. No crystalline structure was found on day 5 in both categories of women, whereas square crystals were observed on day 21 in normal woman. Nature and type of ferning pattern changes seen from days 11 to 14 in normal women were not seen during this period in women who were on oral contraception, instead a thick, viscous mucus was found during the entire period of the cycle.

Adult↗
PubMed1978

Quality control in histopathology and diagnostic cytology.

The need for quality control in diagnostic histopathology and cytology is analysed together with a discussion of previously reported experience in this field. The philosophical and mathematical inferences of this type of exercise are debated also in relationship to personally observed experiences in respect of uterine cervical cytology and histology. The desirability of methods of monitoring of diagnostic quality and of obtaining quality improvement are emphasized and suggestions made regarding the techniques most suited to these objectives.

Carcinoma in Situ↗