[Cervical mucus. 1. Physicochemical properties].
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Cervical mucus was collected from 24 normal (control) women, and 45 cases fitted with Cu T200 IUDs. Glucose concentration was measured by spectrophotometry before and after insertion of the IUDs. In the control group, glucose concentration at midcycle was 1.802 +or- 0.235 mg/gm wet weight cervical mucus. Pre- and postinsertion mean values in Cu T200 users were 0.746 +or- 0.149 mg/gm and 0.487 +or- 0.045 mg/gm of mucus respectively. This decrease in mucus glucose concentration in Cu T200 users may be a factor by which this device affects sperm migration at the cervical level.
35 women of proven fertility who were scheduled for surgical sterilization by salpingectomy were selected for this study; 15 control patients, 10 patients using the Multiload (ML) Cu 250 IUD, and 10 fitted with nonmedicated IUDs. Increased copper concentration did not affect sperm receptivity by the cervical mucus, but did significantly affect sperm motility and survival. Nonmedicated IUDs did not interfere with sperm transport in the oviduct. ML Cu IUDs inhibited sperm transport in the oviduct. The effects of the ML Cu IUD on sperm migration were more evident at the tubal level than at the cervical level.
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Human cervical mucus from women using Lippes Loop and T-Cu-200 IUDs was used to study sperm migration in vitro using flat capillary tubes. Cervical mucus from women bearing no IUD was used as the control. 100% of the control samples, 83% of the Lippes Loop users, and 88% of the T-Cu-200 users had more than 100 spermatozoa/field of 100x. In 17% and in 11% there were between 40 and 100 spermatozoa/field of 100x in the Lippes Loop and T-Cu-200 users. The presence of copper IUDs does not interfere with sperm migration in vitro through human cervical mucus.
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Fertility awareness is experiential learning about cyclic fertility. This awareness, used as a family planning method, differs from contraception because it does not isolate the procreative capacity of either partner. The acceptability and effect of teaching fertility awareness on teen sexual activity and decision making was tested in a multisite pilot program which taught fertility awareness via the prospective marker of the cervical mucus (ovulation method of natural family planning). 200 US and 35 Guatemalan volunteer women ages 15-17 in a structured 1 year curriculum, monitored cycle charting and explored the implications of experiencing one's signs of fertility. Control subjects were recruited from the general population and from family planning clinics. 9% of the US study group were sexually active prior to entry. By cycle 12, 1/2 had discontinued activity. Conception rate was 0.0044. The continuation rate dropped from 90% at cycle 7 to 71% at cycle 8 due to scheduling constraints for 2 classes and to 57% at cycle 12. Postprogram follow-up of early leavers showed only 1/3 the expected rate of onset of sexual activity and pregnancy. Parent involvement correlated positively with postponement and/or discontinuation of sexual activity. Reported movement away from peer group pressure appeared 3 months after entry.
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Specimens of cervical mucus from 7 women fitted with copper IUDs were placed immediately after collection in liquid nitrogen. These specimens were shown by electron paramagnetic resonance measurements to contain statistically significantly higher concentrations of free radicals than similar specimens from 6 women fitted with plastic Lippes loops. Cervical mucus, collected from women immediately prior to elective removal of an IUD, was placed in 2M hydrochloricacid and later analyzed for malonaldehyde using a newly developed polarographic method. Positive results were obtained for 8 of 19 women fitted with copper IUDs, but for none of 21 women fitted with plastic devices. Cervical mucus was similarly collected from 10 women fitted with copper IUDs, 9 women fitted with plastic IUDs, and an additional 9 using other methods of contraception. Mucus was collected 3 times (early, middle, and late cycle). No malonaldehyde was detected in mucus from women with plastic IUDs, or other contraceptive methods. Positive results were obtained in 13 of 29 mucus specimens from those using copper IUDs. Stage of menstrual cycle did not influence the percentage of positive results. Malonaldehyde was detected in vitro in solutions of arachidonate or prostaglandin F2alpha in buffered saline incubated with sterile copper IUD, but not with the plastic. Rate of malonaldehyde production was markedly influenced by pH, temperature, agitation, substrate concentration, and size of gas-liquid interface. the rates of malonaldehyde production around the copper IUD in utero are unknown. The possible increased risk of carcinogenicity associated with the copper IUD is discussed.
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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.