Cervical Mucus Characteristics Research Articles

Effectiveness of Femm Approach in Managing Women with Subfertility in Mwanza, Tanzania

Introduction: Infertility is a disease of the male or female reproductive system defined by the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Approximately one in six people have experienced infertility at some stage in their lives. In Tanzania, the prevalence of infertility is 16%. Most couples suffer from this condition silently without knowing what to do. FEMM (Fertility Education and Medical Management) has come to bring back hope and happiness in these patients. Case series: Here we present four cases of women with subfertility who have suffered for more than five years without being able to conceive. Very interesting they all conceived within two to four months after using the FEMM approach. Currently, they are all pregnant at different gestation ages. Conclusion: Women who are not ovulating cannot conceive. Many times the answers to infertility are hiding in plain sight within the patterns of a woman's menstrual cycle. Failure to ovulate is the first sign of an underlying health condition in a woman followed by irregular cycles. Observing characteristics of cervical mucus is a simple and non-expensive biomarker any woman can tell you about. Fertility awareness together with medical management helped these women to conceive.

Physico-Chemical Characteristics of Cervical Mucus in Repeat Breeder Crossbred Cows Following Ceftiofur Therapy

The present study was carried out to investigate physio-biochemical attributes of cervical mucus following treatment of repeat breeder crossbred cows (HF×K) with ceftiofur crystalline free acid @ 6.6 mg/kg body weight administer separately in two groups of cows through intramuscular (Group-I) and subcutaneous route (Group-II). Each group included 15 repeat breeder cows whose selection was random and based on history of conception failure, gyneco-clinical observation of genitalia and number of artificial insemination per conception. The findings envisaged higher percentage of thick consistency (53.33%) and cloudy colored cervical mucus (93.33%) which returned to their normal characteristics of thin and clear type at post-treatment oestrus in both groups (60.00 and 80.00 %, Group-I; 66.67 and 93.33%, Group-II). The calcium and inorganic phosphorus contents of cervical mucus were significantly higher (p<0.05) at post-treatment oestrus in repeat breeders of Group-I and II whereas total cholesterol declined following treatment (24.05±1.85 and 23.45±1.91 mg/dl) then pre-treatment values (31.12±2.68 and 35.40±4.74 mg/dl) in two groups of repeaters but difference was significant only in Group-I. On the other hand, cervical mucus concentration of sodium, potassium and acid phosphates decreased while total lipids and alkaline phosphatase increased non-significantly at post-treatment oestrus in repeat breeder cows of both groups.
 It is concluded from the finding that ceftiofur therapy of repeat breeder cows was beneficial to restore normalcy of physio-biochemical properties of cervical mucus in both groups.

Gyneco-clinical and microbiological characteristics of cervical mucus in repeat breeder crossbred cows following ceftiofur therapy

Gyneco-clinical and microbiological characteristics of cervical mucus in repeat breeder crossbred cows following ceftiofur therapy

Determination of estrus duration based on cervical mucus characteristics in Aceh cattle using camera-equipped artificial insemination endoscope

This study aimed to determine the length of the estrus period in Aceh cows based on changes in the characteristics of cervical mucus observed using a camera-equipped artificial insemination (AI) endoscope. This study used twelve healthy and reproductively sound cows aged 4-6 years. All cows were synchronized using prostaglandin F2α (PGF2α) injected intramuscularly twice, 11 days apart. Estrus detection was conducted 24 hours following the second injection of PGF2α three times daily for 30 minutes, respectively. Estrous cows were then subjected to the examination of their cervical mucus at 0, 6, 12, and 18 hours after the beginning of estrus. This study showed that out of 12 samples, only eight cows exhibited estrus signs. Characteristics of cervical mucus of cows at 0 and 6 hours of estrus were transparent. At 12 hours of estrus, five cows showed transparency, and the remaining three cows showed cloudy cervical mucus. Meanwhile, at 18 hours of estrus, all sampled cows showed cloudy cervical mucus then regarded as the end of the estrus. That means the estrus length of Aceh cows in this study was 15.75 ± 3.11 hours. It can be concluded that the determination of the duration of estrus in Aceh cows based on changes in the characteristics of the cervical mucus can be carried out using an AI endoscope with a camera. For further research, it is suggested to apply this estrus detection technique in the implementation of AI and determine the pregnancy rate.

Assessing the Pregnancy Protective Impact of Scheduled Nonadherence to a Novel Progestin-Only Pill: Protocol for a Prospective, Multicenter, Randomized, Crossover Study.

BackgroundProgestin-only contraceptive pills (POP) are commonly reserved for women with medical comorbidities but in actuality, POPs can be safely used by anyone wanting to prevent pregnancy. This wide safety profile makes them an ideal candidate for being available over the counter without a prescription, but adherence issues may be more common with over-the-counter use. We need a better understanding of the ability of POPs to prevent pregnancy when adherence issues occur in the form of a missed or delayed pill.ObjectiveThis study aims to determine cervical mucus characteristics following a 6-hour delayed pill intake or after one missed pill as compared to typical daily use of norgestrel 75 mcg.MethodsThis prospective, multicenter, randomized, crossover study assesses the effect of norgestrel 75 mcg (Opill) on cervical mucus and ovarian activity during reported compliant daily use, after a 6-hour delayed intake mid cycle, and after a mid-cycle missed pill. Subject participation will last approximately 4.5 months. We will recruit at 2 US sites: Oregon Health & Science University, Portland, Oregon and University of California Davis Health, Sacramento, California. Reproductive-aged subjects with regular menstrual cycles (21-35 days), BMI <32 kg/m2, and proven ovulation (screening luteal phase progesterone >3 ng/mL [>10 nmol/L]) are eligible to enroll. Participants cannot be at risk for pregnancy during the study period and not use other hormonal methods. Norgestrel 75 mcg will be taken at the same time daily except for one day in each of treatment periods 2 and 3, when the pill will be taken either 6 hours late (delayed pill) or omitted completely (missed pill). Every 3-4 days, we will monitor subjects for follicular activity with transvaginal ultrasound (TVUS) examination, cervical mucus, and blood sampling for ovarian hormones and gonadotropins. Subjects will undergo serial cervical mucus sampling on the days with missed and delayed pill intake at 8 hours after pill intake on the day before the delayed or missed pill, 3 hours following the scheduled time of pill intake if intake was delayed, 6 hours after the scheduled time if intake was omitted, and on the next day 30 minutes before the time of scheduled pill intake. The primary objective of the study is to determine the effect of a delayed or omitted pill intake on cervical mucus characteristics based on a modified Insler score compared to reported daily use.ResultsOur protocol was successfully approved by a central institutional review board (Advarra, Columbia, MD), received ethical approval on March 23, 2018, and was registered with ClinicalTrials.gov (NCT03585712). As of January 2020, the study completed enrollment of 52 subjects. Analyses are pending.ConclusionsOur protocol was approved by a central review board, and study procedures were successfully executed with completed proposed enrollment.Trial RegistrationClinicalTrials.gov NCT03585712; https://clinicaltrials.gov/ct2/show/NCT03585712International Registered Report Identifier (IRRID)DERR1-10.2196/29208

Assessing heterogeneity in menstrual cycles by means of a multilevel latent class approach

ABSTRACT In this paper, we study the problem of heterogeneity in cervical mucus hydration at different times relative to the mucus peak both between cycles and women, specifying and estimating appropriate multilevel latent class models for longitudinal data. We estimate multilevel and growth latent class models which classify women on the basis of the evolution of cervical mucus characteristics observed over the fertile period of each menstrual cycle taking into account that we observe a different number of cycles per woman and correlation over time between consecutive observations. The effect of potential covariates on mucus evolution patterns is as well evaluated. Results confirm the existence of heterogeneity in mucus evolution between cycles and women. Moreover, an important significant effect of a woman’s age is found.

Endometrial Cytology and Cervical Mucus Characteristics of Repeat Breeding Crossbred Cows in Relation to Post-Treatment Fertility

The present study was conducted on repeat breeder (RB, n=40) crossbred cows under field conditions to evaluate their endometrial cytology and cervico-vaginal mucus (CVM) characteristics in relation to post-treatment fertility. The endometrial cytology was obtained using cytobrush technique and CVM by aspiration technique from vaginal fornix using sterile pipette and syringe. The cows yielding bacterial growth in CVM were treated with sensitive antibiotics (i/m) for 3-5 days (Gr I, RBT: 28) and cows not yielding bacterial growth (control, Gr II, RBC: 12) were given 10 ml of normal saline (i/m). The cows were inseminated at subsequent estrus and followed for repeating to estrus and/or pregnancy. The subclinical endometritis was diagnosed using endometrial cytology (PMN%: gereat than 4%) in cows yielding bacterial isolates (n=28) with mean PMN% of 21.80±8.39, 32.18±3.26 and 29.25±6.63 for those having clear stringy consistency, turbid viscous, and watery white flaky CVM, respectively. The mean PMN% in RB cows with no bacterial isolates (n=12) and having clear stringy CVM was 1.50±0.23. The mean values of spinnbarkeit (cm), pH and Whiteside test scores of CVM were 14.60±0.51, 5.82±0.85 and 3.00±0.17; 7.41±0.15, 7.44±0.21 and 7.08±0.19; and 1.40±0.60, 1.91±0.28, and 1.75±0.25, respectively, for culturally positive cows having CVM of clear stringy, turbid viscous and watery with white flakes, respectively (Group I). The mean spinnbarkeit (cm), pH and Whiteside test scores in control cows not yielding any bacterial isolates and having clear stringy CVM (Group II) were 13.08±0.99, 7.37±0.10 and 0.33±0.19. The RB cows with clear stringy, turbid viscous and white flaky CVM and yielding bacterial isolates had mean inter-estrus intervals of 18.80 ±0.51, 15.91±0.48 and 13.83±0.41 days, respectively, the differences being significant (P less than 0.05), with respective post-treatment pregnancy rates of 80.00, 63.63 and 41.66 %, with an overall pregnancy rate of 57.15%. This interval was 19.42±0.45 days in RB control cows, wherein the pregnancy rate was 66.66% without any treatment. The cytobrush technique (PMN%) for endometrial cytology and Whiteside test of CVM were good tools for ruling out the subclinical genital infections in repeat breeding cows.

PENGARUH KARAKTERISTIK LENDIR SERVIK SEBELUM INSEMINASI BUATAN (IB) TERHADAP KEBERHASILAN KEBUNTINGAN SAPI KOMPOSIT

The purpose of this study was to determine the effect of characteristics of cervical mucus before artificial insemination (AI) as conception rate (CR). The study materials were 112 composite cattle in estrus. Fifty five composite heifers and 57 composite cows. Samples of cervical mucus were examined for amount and consistency. The amount of the cervical mucus was studied based on its much, little and nothing of secretion the cervical mucus while the consistency was based on the thinness and thickness of the cervical mucus. The measurement of vaginal temperature was conducted by digital thermometer. The pregnancy diagnosis was performed at the 60th days post insemination. Data was analyzed by descriptive and Chi-square. Findings showed that the conception rates of composite cattle with thin, thick, and nothing secretion of cervical mucus were 66.67%, 68.00%, 35.71% on composite cows and 37.03%, 50.00%, 37.50% on composite heifers. The vaginal temperature with thin, thick, and nothing secretion of cervical mucus were 38.7±1.0 oC, 38.9±0.7 oC, 38.6±0.5 oC. It was concluded that characteristics of servical mucus before artificial insemination (AI) gave effect to conception rate. It was suggested that optimum time to artificial insemination (AI) of composite cattle was on thick and thin secretion of servical mucus. Keywords: Cervical mucus, vaginal temperature, artificial insemination (AI), composite cattle, conception rate (CR).

Characteristics of Cervical Mucus for Estrus Detection in Murrah Buffaloes (Bubalus bubalis)

The objective of the experiment was to study the changes in different characteristics of cervical mucus of Murrah buffaloes in relation to occurrence of estrus. The Murrah buffaloes maintained at Livestock Research Centre (LRC), ICAR-NDRI, Karnal were classified into three groups viz. heifers, primipara and pluripara. Cervical mucus was collected on the day of estrus prior to the artificial insemination by aspiration from the mid cervix using blue sterile sheath and Universal artificial insemination gun through recto-vaginal method. Immediately after collection, mucus sample was taken to the laboratory various physical and chemical parameters were assessed. From the present study it can be concluded that the changes in cervical mucus characteristics can be used for prediction of estrus time and subsequently time of artificial insemination. Murrah buffaloes exhibited higher proportion (70%) of copious discharge, 86% buffaloes had clean appearance and 68% of buffaloes showed moderate consistency of cervical mucus. The spinnbarkeit value of cervical mucus of 46% of estruses were in 8–16 cm and 58% showed the typical fern pattern predominantly with primary, secondary and tertiary venation. pH of cervical mucus were within 7.5–8.0 and conductivity in a range of 13.50–15.00 mS/cm.

Cervical mucus characteristics and hormonal status at insemination of Holstein cows.

The present study was carried out to characterize the cervical mucus (CM) collected when inseminating Holstein cows and to relate the secretion pattern with pregnancy. The mucus was collected from mid-cervix of 64 cows with spontaneus estrus (SE) and induced estrus (IE). The quantity, pattern and consistency of the mucus, pH, arborization patterns and the sperm motility were observed. The levels of progesterone and estradiol 17β in serum were also determined. Pregnancy detection was performed by means of transrectal ultrasonography 60 days after insemination. Mucous secretion of cows with SE was significantly different from those with IE, showing a lower degree of crystallization (SE 2.00; IE 2.75) and a lower level of steroid hormones (P4: SE 0.17 ng/ml and IE 0.33 ng/ml (t 1.99547 α 0.05); E2: SE 30.95 pg/ml and IE 47.76 pg/ml (t 1.99495 α 0.05). Progesterone level was significantly lower and estrogen significantly higher in pregnant cows (P) in relation to that observed in non pregnant females (N) (P4: P 0.20 ng/ml and N 0.44 ng/ml (t 1.99602 α 0.05); E2: P 54.77 pg/ml and N 40.75 pg/ml (t 1.99505 α 0.05). In conclusion pregnancy was associated with acopious, clear and watery discharge (similar to egg white), with an arborization degree of 2.25, presence of atypical fern leaves together with rosette formations and needles or thorns on rails due to low levels of progesterone accompanied by high concentrations of estrogens.

Studies on Estrual Cervical Mucus of Repeat Breeding Cows with Special Reference to Ovulatory Disturbances and Genital Infection

A total of 100 crossbred Jersey cows comprising of 80 repeat breeder presented for treatment and 20 clinically healthy (control group) animals presented for artificial Insemination at their first service within 60–90 days following calving were selected. Estrual cervical mucus were examined for physical properties and white side test (WST). Effects of ovulatory disturbances and non specific bacterial genital infection on physical properties of cervical mucus were also determined. The volume, colour, consistency, stringiness, fern pattern and spinnbarkeit values of cervical mucus were not affected by ovulatory disturbances, while, colour, consistency and pH showed significant (p < 0.01) changes due to non-specific bacterial genital infection. The results of WST showed significant (p < 0.01) positive correlation (0.484) with bacterial culture. It is concluded that ovulatory disturbances have no impact on altering physical characteristics of estrual cervical mucus; however, colour, consistency and pH of cervical mucus are greatly influenced by nonspecific bacterial genital infection in repeat breeding cattle.

Cervical mucus characteristics and periestrual hormone concentration in relation to ovulation time in Zebu (Sahiwal) cattle

The present study was conducted to determine the association among cervical mucus characteristics, periestrual progesterone (P4) and luteinizing hormone (LH) concentrations and ovulation time in Zebu cattle. In experiment 1 the relationship between cervical mucus characteristics and ovulation time was determined. Cervical mucus was collected from Sahiwal cows (n=60) before artificial insemination from mid-cervix and rheological and chemical properties were studied. Ovulation time was determined by ultrasound examination at 2h intervals starting from the onset of estrus to ovulation. Cervical mucus was copious and thin in 70.2 and 63.2 percent of estrus periods, respectively. Cervical mucus from 57.9 percent of the estruses had a typical arborization pattern. The Means±SEM of pH, electrical conductivity and spinnbarkeit value of the mucus were 7.59±0.06, 15.21±0.15mS/cm and 11.06±1.06cm, respectively. Estrus to ovulation duration was significantly greater (P<0.05) in cows that had 8–16cm spinnbarkeit value of cervical mucus than cows with higher or lower values. In experiment 2 the relationship among peripheral P4, LH concentrations and ovulation time was determined. For this purpose blood samples were collected from 20 Sahiwal cows (10 natural estruses and 10 induced estruses) at 2h intervals from the onset of estrus until ovulation. Peripheral P4 and LH concentrations were measured using bovine-specific ELISA kits. The duration of estrus to LH-peak and LH-peak to ovulation was 2.2±1.62h and 29.45±1.73h in natural estrus and 3.3±0.67h and 32.75±3.62h in induced estrus, respectively. The peak LH value did not vary significantly in synchronised (15.26±2.8ng/mL) and natural estrus (12.67±1.96ng/mL). Plasma P4 concentration on the day of estrus was significantly greater (P<0.05) in the synchronised estruses (1.23±0.23ng/mL) compared to the natural estruses (0.65±0.11ng/mL). The estrus to ovulation interval was significantly (P<0.05) greater when the P4 concentration was >1ng/mL on the day of estrus (36.17±0.73h in natural and 37.57±4.32h in synchronised) compared to <1ng/mL (31.28±1.74h in natural and 28.83±3.61h in synchronised). Taken together, the spinnbarkeit value and arborization pattern of cervical mucus had strong relationship with plasma P4 concentration and ovulation time indicating that the parameters could be used as a tool to decide optimal time of insemination in Sahiwal cattle.

Physical Characteristics of Estrual Cervical Mucus and conception rate in Repeat Breeder Kankrej Cattle

Total of 40 and 20 estrous cervical mucus samples were collected from 20 repeat breeder and 10 normal breeder Kankrej cows, respectively and were examined for color (clear or cloudy), consistency (thin or thick), fern pattern (typical, atypical or nil,), pH and spinnbarkeit. These cows were bred and pregnancy diagnosis was performed at 60 days post breeding. The present observation indicated that cows with thin and clear discharge, alkaline pH and spinnbarkeit >15 cm, showing typical fern pattern were normal breeder, whereas, cloudy, thick, acidic cervical mucus with atypical fern pattern and spinnbarkeit ranging from 7 to 9 cm were repeat breeder cows.

Cervical mucus symptom and daily fecundability: first results from a new database

With the collaboration of Italian centres providing services on natural family planning, a prospective study collected data on 2755 menstrual cycles of 193 women. A database was constructed using information on the daily characteristics of cervical mucus and episodes of intercourse. Taking the day of peak mucus as a conventional marker of ovulation, the database identified the length (12 days) and location of a 'window' of potential fertility, the highest level of conception probability being confined to the central five to six days. Univariate analysis provided evidence of the impact on fecundability of the woman's age and the basic infertile pattern of a cycle. Several analytical approaches highlighted the relationship between daily mucus characteristics and levels of fecundability

Natural contraception using the Billings ovulation method

Objective: The Billings ovulation method (BOM) is a medical model of a natural procreation education method based on scientific observation of the changes in the cervical mucus. In this study weexamined Turkish women's interest in accurate usage of cervical mucus changes in determining the ovulation time.Method: Fifteen regularly cycling women monitored their fertility patterns in30 cycles using the BOM and urine luteinizing hormone (LH) kits. At the end of each cycle, the cervical mucus monitoring chart and LH kits were collected from the subjects and analyzed.Results:The cervical mucus symptoms defined a potential fertile period of 10 days' average length, with the 'peak' mucus characteristic occurring at a mean of day 13.65 ± 2.62 of the cycle. The durationof the LH surge, as observed in early morning urine samples, averaged 5 days, with the peak occurring at a mean of day 13.40 ± 2.58 of the cycle. Data indicated that there was a strong correlationbetween LH in the urine and the peak in self-observed, cervical-vaginal mucus (p = 0.001).Conclusion: This study proved that women can distinguish patterns of ovulation and anovulationby self-detection of variations in cervical mucus characteristics, and that urinary LH levels strongly correlate with ovulation.

Efficacy of methods for determining ovulation in a natural family planning program

Objective: To evaluate the efficacy in ovulation detection of methods used in natural family planning in comparison with pelvic ultrasonography. Design: Prospective analysis of ovulation detection by natural family planning methods and ultrasonography. Setting: Natural family planning clinic, Department of Obstetrics and Gynecology, University of Naples “Federico II”. Patient(s): Forty healthy women who were highly motivated to use natural family planning. Intervention(s): None. Main Outcome Measure(s): Transvaginal ultrasonographic findings, urinary LH levels, salivary β-glucuronidase activity, salivary ferning levels and characteristics of cervical mucus, and BBT. Result(s): Urinary LH level determination yielded a 100% correlation with the simultaneous ultrasonographic diagnosis of ovulation. Mucus sensations and characteristics yielded a 48.3% correlation when simultaneously evaluated with ovulation. β-Glucuronidase levels yielded a 27.7% correlation. The salivary ferning test had a 36.8% ovulation-detection rate the day of ovulation, but 58.7% of results were uninterpretable. Body temperature measurements yielded a 30.4% correlation with the simultaneous ultrasonographic diagnosis of ovulation. Conclusion(s): Measuring urinary LH levels is an excellent method for determining ovulation. Although variations in mucus characteristics and basal body temperature correlate somewhat with ovulation, the length of the fertile period is overestimated with these methods. The salivary ferning test and measurement of β-glucuronidase levels are not good methods for home ovulation testing.

What Nurses Should Know About Natural Family Planning

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.

Evaluation of the postcoital test in cycles involving exogenous gonadotropins

To evaluate the hypothesis that a postcoital test, optimally performed in the periovulatory period of cycles in which gonadotropin-induced superovulation was used, correlates with cycle fecundity. Of 1135 total consecutive cycles, 367 first cycles were analyzed from the reproductive endocrinology and infertility service of a university medical center. This referral population had a mean age of 34.6 years for the female partner, a nulliparity rate of 81%, and a mean length of infertility of 4.8 years. Postcoital tests were performed 36-40 hours after hCG administration in gonadotropin-stimulated cycles. Clinical pregnancy was defined as fetal cardiac activity as seen on transvaginal ultrasound examination. Couples with no sperm observed per high-power field in the cervical mucus achieved a 16% fecundity rate (21 pregnancies in 129 cycles), one to ten sperm a 18% fecundity rate (28 pregnancies in 154 cycles), and more than ten sperm a 15% fecundity rate (13 pregnancies in 84 cycles). There was no significant difference between groups (n = 367, P = .85); the power to detect a statistically significant difference was .82. As validation of optimal cervical mucus, fecundity rates were compared with these postcoital test values across the entire range of peak periovulatory serum estrogen levels, and no correlation was seen (P = .61, .86, and .96 for estrogen levels of 201-500, 501-1500, and 1501-3433 pg/mL, respectively). With precise periovulatory timing and supraphysiologic estrogen levels optimizing qualitative cervical mucus characteristics in gonadotropin-induced cycles, the number of sperm observed per high-power field does not correlate with cycle fecundity.

Levonorgestrel levels in serum and uterine flushings in women bearing LNG-Cu-IUD.

Radioimmunoassay was employed to measure levonorgestrel levels in serum and uterine flushings in women using intrauterine device releasing both copper ions and levonorgestrel (LNG-Cu-IUD) after one-year insertion. In the meanwhile physical characteristics of cervical mucus have been observed in women using LNG-Cu-IUD and compared with those using Tcu-220c-IUD. The mean concentrations of levonorgestrel in serum and uterine flushings (5 ml) were 84.53 pg/ml and 266.93 pg/ml respectively. In LNG-Cu-IUD group, the cervical mucus lacking in ferny crystals had a viscosity significantly higher than that in Tcu-220c-IUD group, suggesting that the local high concentration of levonorgestrel changed the environment of the uterine cavity and the cervical mucus status.

Symptothermal and hormonal markers of potential fertility in climacteric women

One hundred seventy-seven menstrual cycles in 36 women between 45 and 53 years of age were studied prospectively. All the women were experienced in the symptothermal method of natural family planning. The objective was to determine the symptothermal and hormonal indices of potential fertility by measuring urinary estrone glucuronide and pregnanediol glucuronide. Thirty-three percent had regular cycles consistent with potential fertility, 19% had cycles consistent with infertility, and 47% had a mixture of both types of cycle.