Psychology as vital as technology in natural family planning.
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The problem of an exact timing of the HCG administration in stimulated cycles (for infertility problems) is of primary importance for optimizing the results. In this study the authors show the results obtained in two groups of patients to whom HCG was administered according to two different methods of monitoring: the first biochemical, the second biological. The examination of the results has proven that the insertion of the biological method (cervical mucus) among those used in the monitoring has allowed a significant increase of the biological response to treatment.
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BACKGROUND: This study was undertaken to investigate changes in the forms of hyaluronan and hyaluronidase activity in cervical mucus during cervical ripening. METHODS: Uterine cervical mucus was obtained from 57 pregnant women (25 at preterm gestation, ten at term gestation, 11 within 1 week before labor, and 11 during the first stage of labor). We determined 1) concentration of hyaluronan, 2) hyaluronidase activity, and 3) molecular weight of hyaluronan in cervical mucus. Data are presented as mean and range. RESULTS: The hyaluronan concentration in mucus in the 1st stage of labor (1.58 microg/ml, 0.46-23.96) was significantly (p<0.05) higher than that in all other groups (preterm: 0.29, 0.10-0.88; term: 0.24, 0.11-0.80; within 1 week before labor: 0.30, 0.18-0.62). Hyaluronidase activity both within 1 week before labor group (3.03 min., 1.12-3.95) and in 1st stage of labor group (3.52, 0.43-5.15) was significantly (p<0.05) higher than that in preterm group (1.70, 0.00-5.47). The molecular weight of hyaluronan in cervical mucus in the 1st stage of labor (0.97x106, 0.86-1.41) was significantly (p<0.05) lower than in the preterm and term groups (preterm: 1.60, 1.21-2.20, term: 1.41, 1.21-2.20). There was a significant correlation between hyaluronidase activity and molecular weight of hyaluronan (p<0.05, r=-0.41, n=23). CONCLUSION: These findings suggest that either hyaluronidase or low-molecular weight hyaluronan could be one of the most important regulators in the process of cervical ripening.
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Midcycle cervical mucus was obtained from 56 women. Each mucus sample was divided into four portions collected into a capillary tube and kept either at room temperature or at 4 degrees C, -20 degrees C or in liquid nitrogen for 1 h, afterwards thawed at 37 degrees C and used in the in vitro penetration device for 1 h. 56 semen samples of good quality were used, the same sample for all four types of the same cervical mucus. Very high significant correlations were calculated between the penetration value (PV) rates in all four methods of cervical mucus preservation. Paired t test revealed a significant decrease (p less than 0.025) in the PV rates of sperm in the cervical mucus cryopreserved in liquid nitrogen. The results of this study recommend the establishment of a cervical mucus bank using the 4 degrees C and -20 degrees C as possible methods for preservation of cervical mucus.
Two common natural family planning (NFP) methods are the ovulation method based on characteristics of cervical mucus and the symptothermal method based on changes in cervical mucus, basal body temperature, and the cervix. Both methods are effective when used correctly. Nurses should understand the principles of NFP and introduce these methods in discussions of family planning options. Interested clients should be referred to a certified NFP instructor for education and supervision.
A study of the knowledge, perceptions, and behavioral intentions of physicians regarding periodic abstinence (PA) methods was undertaken in Mauritius, Peru, the Philippines, and Sri Lanka. Most respondents considered PA to be useful, although even the PA providers prescribed mainly non-PA methods. Detailed knowledge of PA methods was not evident, but most physicians were willing to initiate general discussion about PA with patients. Physicians favored methods perceived as "scientific" and "modern," which primarily prevent pregnancy and secondarily avoid other health risks. When carefully presented as "scientific" and "modern," methods presented to medical audiences may find acceptance and be more likely to result in referral.
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A marked increase in acceptance of the ovulation method of contraception, together with promising method and user failure rates, were revealed in this study of women to whom a system of combining the ovulation method with the optional use of a diaphragm, advisedly as a menstrual seal, was offered.