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Billings natural FP method: correlation of subjective signs with cervical mucus quality and ovulation.

Daily self-appraisal of the degree of vulvar humidity sensation by highly motivated and trained volunteers was correlated to actual cervical mucus quality patterns and time of ovulation. Sixty-two ovulatory cycles were studied. Humidity degrees reported by the women showed a highly significant correlation with simultaneous values of cervical mucus spinnbarkeit and crystallization. On the other hand, ovulatory days were also closely related to the days reported with maximal (+++) humidity degree. In summary, the correct appraisal of vulvar humidity may provide consistent information on both cervical sperm penetrability and ovulation predictions; these in turn could complement each other in ascertaining the potentially fertile period of the cycle.

Cervix Mucus↗

The midcycle cervical microbial flora as studied by the weighed-swab method, and its possible correlation with results of sperm cervical mucus penetration tests.

Infertile couples undergoing routine investigation for infertility were randomly selected for the study. A quantitative method using weighed swabs was found satisfactory for the study of microbial flora in the midcycle cervical mucus. In 6 of the 20 women, the midcycle cervical mucus was hostile in the sperm cervical mucus penetration tests. The total bacterial counts and the number of species (average, 2.5) isolated from the hostile mucus were significantly greater than those from the receptive mucus (average, 1.3). Only normal vaginal/cervical flora was isolated. Ureaplasma urealyticum was found more frequently in patients undergoing clomiphene citrate therapy (6/10 versus 0/9, P less than 0.03, Fischer's Exact test).

Cervix Mucus↗

Cervical mucus changes in relationship to urinary luteinizing hormone.

In order to evaluate the relationship between the urinary luteinizing hormone (LH) surge as detected by the OvuSTICK (Monoclonal Antibodies, Inc., Mountain View, CA) method and daily cervical mucus parameters, ten spontaneously ovulating women undergoing infertility evaluation were followed during their cycles with twice daily urinary LH testing as well as daily ultrasound, mucus evaluation, and hormonal assays of serum LH, progesterone (P), and estradiol (E2). Maximal cervical mucus scores, as determined using a modified Insler score, were noted to coincide consistently with the urinary LH surge as detected by twice daily testing and to precede ultrasound evidence of ovulation by 0 to 24 hours. Mucus scores rapidly declined in the 24-hour period following the urinary LH surge. Detection of the urinary LH surge may therefore help identify that period of time during which cervical mucus parameters are optimal and therefore facilitate the timing of artificial insemination, intercourse, or postcoital testing.

Cervix Mucus↗

Immunoglobulin levels and phagocytes in the cervical mucus plug at term of pregnancy.

BACKGROUND: To characterize the potential for adaptive immune protection in cervical mucus plugs with respect to immunoglobulin isotypes and effector cells (phagocytes). METHODS: Thirty-one cervical mucus plugs were collected from healthy women in labor at term. The cervical mucus plugs were allocated either to analysis of immunoglobulins by enzyme-linked immunosorbent assay (ELISA), gel chromatography and Western blotting (n = 20) or to microscopical, including immunocytochemical, analyses. The levels of immunoglobulin in the plugs were compared to the levels in 10 samples of ovulatory cervical mucus from nonpregnant women. RESULTS: In the cervical mucus plugs, levels of immunoglobulin G (IgG) [median 3270 microg/mL (100-14 500)] and IgA [540 (22-2820)], but not IgM [30.5 (1.0-160)], were significantly elevated compared to cervical mucus from nonpregnant women (p < 0.02 for IgG and IgA). The IgG : IgA ratio in the plugs was also elevated (p < 0.02). The proportion of secretory immunoglobulin A (SIgA) relative to total IgA in the plugs ranged from 16 to 65% (n = 5). IgA and IgG were largely intact. Microscopically, the vagina-proximal part of the cervical mucus plugs contained bacteria and was rich in cells, mainly phagocytes. Conversely, the uterine part contained few cells. CONCLUSION: The high immunoglobulin levels in combination with the presence of phagocytes suggest a potential for adaptive immune defense in the cervical mucus plug, which, together with innate immune factors, may act as an immunological gatekeeper protecting the fetomaternal unit against infection from the vagina.

Blotting, Western↗

Luteinizing hormone and ovulation timing in a therapeutic donor insemination program using frozen semen.

A series of 110 therapeutic donor insemination cycles was analyzed to determine the impact on fecundity when a urinary luteinizing hormone detection kit was used to plan inseminations. To prevent the transmission of human immunodeficiency virus, frozen semen, thawed after a 90-day quarantine, was used. The minimum standard for insemination with cryopreserved semen was a total of 24 x 10(6) motile sperm per milliliter after thawing. Fecundity was 0.12 when insemination timing was based on cervical mucus evaluation and basal body temperature charts and 0.13 when a urinary luteinizing hormone kit was also used to predict ovulation. Life table analysis with the log rank test showed no statistically significant difference in the number of cycles required to achieve conception between the group of patients using conventional methods of ovulation timing and the group of patients using the urinary luteinizing hormone kit. Urinary luteinizing hormone testing offers no advantage over conventional methods, such as cervical mucus examination and evaluation of basal body temperature, when ovulation is being timed for insemination with frozen donor semen.

Acquired Immunodeficiency Syndrome↗

The rhythm method of contraception.

The rhythm method (safe period) is the only contraceptive method which is approved and actively promoted by the Roman Catholic Church. It therefore holds and attraction to a large number of followers. This paper reviews the historical development of the method from the initial efforts in the nineteenth century to the work of Ogino and Knaus, and covers the variations which are based on alteration of the basal body temperature and changes in cervical mucus. Although this method should be devoid of side effects, certain risks have been reported due to the possible fertilization of an overripe ovum. There may also be a higher risk of ectopic pregnancy than normal to users of this method and these reports are reviewed. The results of field trials concerning the use effectiveness of the method are also examined.

Animals↗

Objective and subjective data for fertile period diagnosis in women: comparison of methods.

The Authors have evaluated the reliability of various methods, both natural and biochemical, for the identification of the female ovulatory period in women with regular periods. They compared these methods among themselves and with echographical checking of ovulation. It emerged clearly from the study that the greatest reliability among the natural methods is obtained through the evaluation of the presence of cervical mucus, while among biochemical methods the best results are obtained by a semiquantitative colorimetric test. Brilliant prospects have also been opened by research on saliva.

Biomarkers↗

High resolution proton magnetic resonance spectroscopy of human cervical mucus.

High resolution 1H NMR spectroscopy is a powerful method for qualitative and quantitative analysis of the highly viscous human cervical mucus (CM). Up to 23 compounds could be identified in this study and can be observed in the 1H NMR spectra of native mucus without the need of any complicated preparative chemistry. Storage conditions could be excluded as a possible reason for variations observed between different samples. pH values decreased after freezing and storing at 253 K. For NMR studies, lyophilization proved to be most useful, allowing the determination of the water content, replacement of H2O by D2O, and most importantly, absolute quantification of low molecular mass compounds. In a small collective of women the concentrations of some of the small constituents of the CM are strongly correlated; an example is the mutual positive correlation of taurine, citrate and creatinine. In conclusion, high resolution 1H NMR spectroscopy is a valid method to investigate mucus composition and to determine absolute concentrations of low molecular mass compounds in CM.

Adult↗

Enzymes of human cervical mucus: a comparative study on fertile and infertile mucus and on the endocervical epithelium.

We report a comparative study on protein and enzyme content of human periovulatory cervical mucus and endocervical epithelium. The salient results of our investigation are summarized in the following three points: 1) The method of taking of cervical mucus samples may markedly affect the results of protein and enzyme assays. It is warmly advisable to collect mucus samples from the endocervical canal. 2) Cervical mucus from women diagnosed as having cervical-factor infertility is oligoproteic and lacks some enzyme activities always present in normal cases. 3) Human cervical mucus and endocervical epithelium are very similar as for the enzyme distribution, but show quite different LDH-isoenzyme patterns. In the latter tissue, the H subunits constitute about 77 per cent of the whole LDH, suggesting that this enzyme here is functioning to produce pyruvate rather than lactate.

Adult↗

Do autoantibodies to sperm reduce fecundity? A mini-review in historical perspective.

PROBLEM: The paradox that early studies of antisperm antibodies in men showed a strong correlation between titers of circulating antibodies (essentially immunoglobulin [Ig] G) and reduction in conception rates, whereas more recent studies have indicated that the antifertility effect is mainly (or exclusively?) associated with IgA antibodies, impairing sperm migration through cervical mucus, was studied. METHOD OF STUDY: Relevant literature focusing on antibodies on ejaculated sperm was analyzed. RESULTS: Direct mixed antiglobulin reaction (MAR) and immunobead-binding tests are excellent and sensitive techniques for demonstrating antibodies of the IgG and IgA classes on sperm, and they have revealed that IgA antibodies are, with very rare exceptions, found only when IgG antibodies are also present. However, these tests tell little about the amounts of antibodies present, and attempts to measure quantitatively the amounts of Ig on sperm have indicated higher levels of IgA than IgG (despite the strongest MAR reactivities for IgG). CONCLUSIONS: The patients with high levels of IgA to their sperm are mainly men with strong immune responses and, therefore, also high antibody titers in serum. Apparently, the locally produced IgA antibodies reach the sperm and occupy the binding sites before the main bulk of IgG reaches the seminal compartment with the prostatic fluid.

Autoantibodies↗

[Fatty acid composition of the cervical mucus obtained during ovulation and at the term of pregnancy].

BACKGROUND: Aim of this work is to evaluate the different fatty acid composition of cervical mucus obtained during ovulation and at the term of pregnancy. METHODS: The fatty acid composition in cervical mucus was determined in 14 non pregnant women during expected ovulation (cervical score > 10) and in 12 at term pregnant women. Following extraction, (acidification and transesterification), the identification and quantification of fatty acids was performed by gas-chromatographic analysis, with the aid of a specific software. RESULTS: In both groups of samples, palmitic acid, stearic acid and oleic acid were the prevalent acids comprising more than half of the total amounts. Compared to non pregnant samples, in pregnant cervical mucus, elevated levels of oleic acid were pointed out, while mean levels of miristic acid and stearic acid were lower. In the samples of cervical mucus drew at the term of pregnancy, arachidonic acid levels mean values were higher when the first period of labour was started. CONCLUSIONS: The pregnancy-induced biochemical changes in fatty acid pattern could likely be correlate to the variations of the physiochemical properties and to the physical appearance that cervical mucus undergoes during pregnancy. The elevated levels of arachidonic acid, during the first period of labour, may be correlated with prostaglandin production by intrauterine tissues (amniotic fluid, amnion, chorion, decidua, myometrium) and probably by cervical mucus.

Adult↗

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↗

DNA identification of fetal cells isolated from cervical mucus: potential for early non-invasive prenatal diagnosis.

OBJECTIVES: To develop a reliable method to isolate fetal cells for genetic diagnosis. DESIGN: Aspiration of cervical mucus from pregnant women in the first trimester. SETTING: Pregnant women were recruited before an elective termination of pregnancy. POPULATION: Sixty pregnant women (7-10 weeks of gestation). METHODS: Fetal cells were isolated from aspirated cervical mucus of pregnant women using a combination of enzymatic digestion, fluorescent immunohistochemistry, micromanipulation and single-cell DNA allelic profiling. MAIN OUTCOME MEASURES: The isolation and identification of fetal cells. RESULTS: The transformation of the tenacious cervical mucus into a single-cell suspension enabled the isolation and identification of fetal cells by fluorescent immunohistochemistry. Confirmation of fetal origin was accomplished by single-cell DNA allelic profiling alongside known maternal cells. CONCLUSIONS: This novel non-invasive method is rapid and efficient with results attainable within 24 hours as early as seven weeks of gestation. The technique would offer earlier reassurance and the option of first trimester therapeutic abortions to both high and low risk pregnant women.

Cervix Mucus↗

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↗

Overview of the biological aspects of the fertile period.

The fertile period of the human menstrual cycle consists of those days on which sexual intercourse can result in a pregnancy. Its duration is determined by the functional life span of the gametes within the female reproductive tract. Various mechanisms control gamete transport and survival in the reproductive tract of the human female. The ovarian hormones estradiol and progesterone have an important role in regulating these mechanisms. The nature of cervical mucus and its governing influences on sperm transport and survival following coitus are of prime importance in defining the fertile days of the menstrual cycle. Man's early concepts of the fertile period were often based on erroneous theories of the female reproductive cycle. It is only since the late 1920's that a true understanding of ovulation and the menstrual cycle has evolved. Current approaches in natural family planning to recognizing the fertile and infertile days of the menstrual cycle are discussed and evaluated.

Cervix Mucus↗