Properties Of Cervical Mucus Research Articles

Ovarian function after seven years' use of a levonorgestrel IUD.

Fifteen women with regular menstrual periods and seven amenorrheic women who had been using a levonorgestrel-releasing (LNg) IUD for more than seven years were studied. For controls, eight women using TCu380Ag IUDs for more than seven years were studied during two complete menstrual cycles. Ovarian function was assessed with hormonal determination and ultrasound examinations. The regularly menstruating women were studied for two complete menstrual cycles and the amenorrheic women for eight weeks. In the regularly menstruating LNg-IUD users, according to progesterone levels, 93% of the cycles were ovulatory but just 58% of these 'ovulatory' cycles showed normal follicular growth and rupture. Follicular cysts and luteinization of regressing follicles were observed in 42% of the 26 'ovulatory' cycles studied. SHBG capacity was decreased in the LNg-IUD users compared with the TCu380Ag users. Progesterone levels were lower in the LNg-IUD users compared with the TCu380Ag users but this difference was not statistically significant. Preovulatory estradiol and LH levels were lower in the LNg-IUD users than in the TCu380Ag users. These differences were not statistically significant. For the amenorrheic women, five had follicular cysts that disappeared spontaneously within 45 days. Two women showed follicular development and rupture. The presence of good cervical mucus was observed in 69% of the ovulatory cycles studied in the LNg-IUD users. This indicates that effects on cervical mucus cannot be the main mechanism of action of the LNg-IUDs. It is concluded that LNg-IUDs may exert a contraceptive effect in many different ways, such as inhibition of ovulation, endometrial changes preventing implantation, alteration of physical and chemical properties of cervical mucus affecting sperm transport and subtle disturbances in hypothalamic pituitary ovarian function, resulting in alterations of follicular development and rupture.

Controlling the swimming speed of human sperm by varying the incubation temperature and its effect on cervical mucus penetration.

The objective of the present experiments was to study the effect of sperm velocity as a single variable on the ability of sperm to penetrate cervical mucus in a modified Kremer test. Sperm incubated at 13, 22 and 37 degrees C exhibited progressive velocities of 25 +/- 1.7, 40 +/- 2.1 and 56 +/- 2.1 microns sec-1 (mean +/- SEM, n = 6) respectively, but the percentage of progressively motile sperm, their lateral head displacement and the viscoelastic properties of cervical mucus remained comparatively unchanged over this temperature range. The number of sperm which penetrated the mucus and the percentage of successful collisions were correlated strongly with the average velocity of the sperm population (r = 0.82 and r = 0.72 respectively). It is concluded that sperm velocity has an important influence on the penetration of cervical mucus because it governs the frequency of collisions with the mucus interface and is determined by the thrust generated by the flagellum which also determines the ability of the sperm to traverse the mucus interface.

Treatment of cervical mucus with lectins: effect on sperm migration.

Treatment of midcycle human cervical mucus with the lectins Ulex europaeus agglutinin I (UE), wheat germ agglutinin (WGA), and peanut agglutinin (PA) did not alter the ability of spermatozoa to enter and migrate through the mucus. These lectins form glycoconjugates by binding to L-fucose (UE), N-acetylglucosamine and sialic acid (WGA), and D-galactose and D-galactose-(1-3)-D-N-acetylgalactosamine (PA), sugars that are present in the carbohydrate side chains of the mucus glycoproteins (mucins). Ricinus communis, with high affinity for D-galactose and N-acetylgalactosamine, did cause a significant decrease in sperm migration but only within the mucus (not at the sperm-mucus interface); this may have been because of an effect on sperm motility. These sugars are thought to be important for the secondary structure of the glycoproteins and for the cross linking between the mucins that produce the rheologic properties of cervical mucus. However, it appears that interference with the sugars by lectin binding does not significantly alter the ability of spermatozoa to migrate through cervical mucus.

Cervical mucus immunoglobulins as an indicator of ovulation.

A practical and accurate method of determining ovulation using cervical mucus is described. Ovulatory cycles from 32 healthy women were assessed using hormonal and nonhormonal methods. Cervical mucus extractable immunoglobulins were assayed for the complete cycles of nine women and randomly collected from 23 additional women with normal cycles. All normal ovulatory women showed a minimum concentration present at midcycle when optimum conditions for fertilization existed. Using newer laser nephelometry techniques, the content of extractable immunoglobulin G and immunoglobulin A per sample weight confirmed the cyclic nature of the concentration of immunoglobulin in cervical mucus, and correlated well with previously defined biophysical properties of cervical mucus. Nephelometry proved to be rapid, accurate, and an inexpensive technique for determining ovulation and has potential for clinical use.

Chemical alteration of cervical mucus by electrolytes

Scanning electron microscopy and energy-dispersive x-ray analysis have been used, together with conventional light microscopy and sperm penetration tests, to evaluate the alteration of cervical mucus composition and properties during the menstrual cycle and subsequent to exposure of cervical mucus to electrolytes in vitro and in vivo. Alteration of the electrolyte content of cervical mucus appears to offer a means for the predictable control of cervical mucus properties and penetrability by sperm. This method may have clinical application in both reduction and enhancement of fertility in the human.

Mechanical Properties of Cervical Mucus

Mechanical Properties of Cervical Mucus

Cyclic changes in glycoprotein synthesis and secretion by the human endocervix.

The aim of our study was to investigate whether the well-known variations in properties of cervical mucus during the menstrual cycle possibly have their basis in synthetic and secretory behaviour of the mucous glycoprotein (M.G.) producing columnar cells, lining the endocervix.KeywordsColumnar CellCervical MucusOvulatory PhaseBasal Body TemperatureMucous GlycoproteinThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

The clinical significance of rheometric measurement of cervical mucus properties.

Rheometric properties of cervical mucus were studied with the Ovutimer in 26 women. 14 women had regular menstrual cycles, 12 had menstrual irregularities and received treatment to induce ovulation. In 21 women (80.7%) a significant correlation was found between the ovulation time as established by the luteinizing hormone surge, and ovulation time as established by the Ovutimer test. The instrument was found satisfactorily accurate in establishing the day of ovulation in almost all cases.

Prostaglandin E 1 increases blood flow to the cervix uteri

PGE 1 occurs in high concentration in seminal fluid and is apparently necessary for normal fertility, although its specific function(s) is not known. We investigated the possibility that PGE 1, at seminal fluid concentration, could increase cervical blood flow and, thus, potentially alter cervical mucus properties, including 0 2 concentration. Fifteen μg PGE 1/ml placed directly on the cervix uteri increased cervical blood flow in anesthetized dogs from 0.8±0.7 to 5.7±5.1 ml/gomin 5 min following application without affecting arterial pressure or hepatic or renal blood flow. Seminal PGE 1 may have effects upon oxygen tension in the cervical mucus, as well as aiding leukocyte accumulation in the cervical canal, by increasing cervical blood flow.

Effects of norgestimate in combination with ethinyl estradiol on cervical mucus.

The antifertility effect of norgestimate (Ng) 0.125 mg in combination with ethinyl estradiol (EE) 0.035 mg on cervical mucus of 5 apparently normal and ovulatory volunteer women was studied for 2 cycles: a control cycle followed by a study cycle in which the medication was given. Throughout both cycles, basal body temperature, cervical mucus properties, sperm penetration in cervical mucus and karyopyknotic index of vaginal cells were evaluated. Disappearance of cyclicity of these parameters in the study cycle as well as monophasic basal body temperature were suggestive of inhibition of ovulation caused by the combination pill. Deterioration of cervical mucus properties throughout the study cycle and inhibition of sperm penetration may be a reflection of anovulation. However, a direct antifertility effect of Ng on cervical mucus cannot be excluded.

The Effect of a Synthetic Progestogen, Ethylnorgestrienone, on Hypothalamic-Pituitary-Ovarian Function, Cervical Mucus, Vaginal Cytology, and Endometrial Morphology

The antifertility mechanism of a new progestin preparation, ethylnorgestrienone (13 beta-ethyl-17 alpha-ethynyl-17-hydroxy-gona-4,9,11-triene-3-one) (R2323), was evaluated. The compound was administered orally in doses of 5 mg weekly to seven subjects for a total of nine treatment cycles. Each woman served as her own control and was studied during a normal menstrual cycle followed by a cycle in which she received R2323. Serum concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and progesterone, as well as cervical mucus properties, were studied serially during the control and treatment cycles. Results indicated that all control cycles were ovulatory. Ovulatory gonadotropin patterns were observed in four treated cycles, but preovulatory FSH and LH peaks and progesterone production during the luteal phase were suppressed significantly. Estradiol levels showed an early increase during the follicular phase and a significantly decreased preovulatory peak. Cervical mucus properties were altered and sperm penetration in cervical mucus was inhibited in all treatment cycles. These findings suggest that at least two different factors might be involved in the contraceptive mechanism of R2323: (1) alteration of the ovulatory process and progesterone production, and (2) cervical mucus changes leading to inhibition of sperm migration.

Return of Ovarian Function and Endometrial Morphology in Women Treated with Norethisterone Oenanthate: A Pilot Study

A comparative pilot study was undertaken in three centers to determine the time of return of ovulation after the injection of the steroidal contraceptive norethisterone oenanthate (NET-OEN). The effect of the compound on the endometrium and some properties of cervical mucus were also assessed. Increases in plasma progesterone levels suggested that ovulation resumed in all six women in Bahia within 60 days of injection of NET-OEN, whereas in Bangkok and New Delhi only two women in each center ovulated within this time. The difference in the time of return of ovulation between women in Bahia (mean time 42 days) and those in Bangkok and New Delhi (92.5 days) was statistically significant. Follicular function returned earlier than luteal function: all six women in Bahia and Bangkok and five of the six in New Delhi showed evidence of follicular activity within 60 days. All endometrial biopsies, obtained at a time of increased progesterone production, were secretory and suggested that administration of the gestagen did not exert a prolonged suppression of endometrial activity. In general, changes in cervical mucus were consistent with variations in plasma steroid levels.

Human Cervical Mucus and its Mucous Glycoprotein during the Menstrual Cycle

Human cervical mucus was collected serially during the menstrual cycles of each of 10 healthy women. After fractionation by equilibrium density centrifugation in CsCl, the sugar composition of the fractions containing mucous glycoprotein (MG) was examined by gas-liquid chromatography. No cyclic variations were detected in the sugar composition of MG (including sialic acid) or in its electrophoretic behavior. The composition of the mucus varied greatly during the cycle. Near ovulation the ratio of proteins to MG was minimal. During the luteal phase this ratio rose quickly. The secretion of MG was high during ovulation. The concentrations of the other proteins. The composition of cervical proteins was mapped by sodium dodecyl sulfate-polyacrylamide gel electrophoresis.

Prediction and Detection of Ovulation

This paper reviews and evaluates various methods for the prediction and detection of ovulation, with emphasis on the role this plays in management of infertility and in natural family planning. After spelling out the hormonal events which control the ovulatory process, techniques for ovulation detection and timing are discussed. These fall into 2 classifications: 1) direct assays of gonadotropins or steroid hormones in the serum or urine; and 2) evaluation of peripheral changes preceding, coinciding with, or succeeding ovulation. Since serial hormone assays are not practical in routine clinical practice, clinicians generally rely on peripheral or end-organ changes to determine alteration in circulating steroid hermone levels, but direct assays of gonadotropins and sex steroids would have to supplement these methods to determine the accuracy of commonly performed methods of ovulation detection. Tests based on hormone assays include daily assays of 1) serum or urinary lutienizing hormone (LH), 2) urinary estrogens (or estrogen metabolites) or serum estradiol, and 3) serum progesterone or urinary pregnanediol. Each assay is described in the text. Tests based on peripheral and systemic changes include ]) basal body temperature changes, 2) tests of physical properties of cervical mucus (appearance, spinnbarkheit, ferning, and burn test), 3) tests of the chemical content of cervical mucus (protein constituents and enzymes), 4) endometrial biopsy, 5) vaginal cytology, and 6) saliva sampling (measuring alkaline phosphatase levels which generally increase at time of ovulation). Tests based on hematologic changes, especially the decrease of blood basophil count at ovulation, are also discussed. Among the possible techniques of natural family planning discussed are the calendar method (Ogino-Knaus), the cervical mucus (ovulation) method, and the symptothermic method (basal temperature and calender combined) method.

Effect of prostaglandin F2 alpha on sperm transport in the reproductive tract of female macaques (M. fascicularis).

This investigation was designed to evaluate the effect of prostaglandin F2α on sperm transport and the fate of spermatozoa in the primate reproductive tract of nonhuman primate. Six adult female crab-eating macaques were bred at midcycle to males of known fertility and sperm quality. Treated (3) and untreated (3) females were matched with regard to amount and properties of cervical mucus, follicular maturation as determined by laparoscopy and preovulatory LH surge. Prostaglandin F2α was administered in four subcutaneous injections of 2.5 mg each every 2.5 hr, between mating and autopsy. Twelve hours after mating the reproductive tract was fixed in vivo. Sagittal sections were made from the cervix and uterine corpus. Longitudinal serial sections were made from the oviducts. Spermatozoa were counted in histological sections. The mean values, standard error and ranges were evaluated for treated and untreated animals, using Student's t-test for statistical analysis. The significantly higher numbers of spermat...

Estrogen and Progestin Binding and Changes in Secretions by Human Cervical Tissue During the Ovarian Cycle

Sex steroids have a significant influence on a variety of biophysical, biochemical, and immunologic properties of cervical mucus; examples are the fluctuations in the concentration of soluble proteins in mucus during the ovulatory cycle. Estrogens reduce the concentrations of both indigenous and serum proteins found in cervical mucus. In contrast, progestins cause these concentrations to increase, even in the presence of substantial amounts of serum estrogens (Schumacher et al.: Am J Obstet Gynecol 129:629, 1977). In an attempt to correlate functional events of the cervix with steroid receptor activity and serum concentrations of sex steroids, cytoplasmic estrogen- and progestin-binding capacities were measured in cervices collected at hysterectomies performed during the proliferative, midcycle, and secretory phases. The ovarian endocrine status was determined from morphologic criteria for the endometrium and from serum concentrations of estrogens and progesterone. Concentrations of lysozyme, albumin, and immunoglobulin G (IgG) in cervical mucus were also measured as indices of ovarian endocrine status and cervical function. Progestin binding in the cytosol of the cervix was 0.9 ± 0.4 fmole/mg wet weight ± SEM in early to midfollicular specimens, 2.3 ± 0.6 fmoles/mg wet weight ± SEM at midcycle, and was less than 0.3 fmole/mg wet weight in luteal phase specimens. No differences could be detected in cytoplasmic estrogen-binding capacity among the specimens collected at the early to midfollicular, midcycle, and luteal phases (2.2 ± 0.7, 3.6 ± 0.9, and 1.9 ± 0.3 fmoles/mg wet weight ± SEM, respectively). Serum estradiol levels were higher (P < 0.05) for luteal phase specimens (114 ± 8 pg/ml ± SEM) than for early to midfollicular phase specimens (54.3 ± 15 pg/ml ± SEM), yet the IgG, albumin, and lysozyme concentrations of cervical mucus were apparently similar for the luteal and early to midfollicular phase specimens. These observations are consistent with a hypothesis that progestins reduce cellular responsiveness to the estrogen-receptor complex.

PHARMACODYNAMIC STUDIES WITH A NEW PROGESTATIONAL SUBSTANCE ‐ ORG 2969 ‐ IN COMBINATION WITH ETHINYLOESTRADIOL

A new orally active progestin ORG 2969 (13-ethyl-ll-methylene-1819-dinor-17 alpha-pregn-4-en-20-yn-17-ol) was studied in combination with ethinyl estradiol (EE) to determine its ability to suppress ovulation and its effects on peripheral functions in human volunteers. .015 .03 .075 .1 and .125 mg of Org 2969 combined with .05 mg of EE; .05 mg of Org 2969 plus .03 mg of EE; or .15 mg of Org 2969 plus .02 mg of EE formulations were tested in 21-day cyclic regimens. In addition 2 normophasic regimens were tested. The 1st cycle in all dose groups served as control. Treatment cycles lasted up to 8 months. In 21 volunteers the 1st post-treatment cycle was also studied. During every cycle serum luteinizing hormone estradiol and follstimulating hormone were measured daily on Days 7-23 and serum progesterone on Days 14-23. Basal body temperature cervical mucus properties vaginal smears and endometrial biopsies were also observed routinely. Hormone determinations are presented in graphs; results suggested that all pretreatment cycles were ovulatory and all treatment cycles were anovulatory. In the majority of patients the 1st post-treatment cycle was ovulatory. Endometrial biopsies showed normal secretor pattern during pretreatment drug related changes during treatment and close to normal secretory pattern during post-treatment cycles. The other peripheral paramenters studied were also in accord with hormonal determinations.

Effect of LH-RH peptide antagonist on serum LH, ovulation and menstrual cycle of crab-eating macaque

The effects of the antagonistic LH-RH analogue, D-(PHE 2)-D-(ALA 6)-LH-RH (Wy-18,185), were studied in the female crab — eating macaque ( Macaca fascicularis ) with emphasis on length of menstrual cycle, length and intensity of menstrual bleeding, serum LH, quantity and properties of cervical mucus, growth of the follicle and ovulation during the treatment and subsequent control cycles. Prior to the expected ovulation, the compound was administered subcutaneously, 25 mg/kg body weight/day, for 3 or 6 days. Blood was collected daily before, during and after treatment. Cervical mucus characteristics were charted daily. Laparoscopy was performed 2–4 days after presumed ovulation. Neither the length of the menstrual cycle nor the quality of the cervical mucus were dramatically altered during treatment with Wy-18,185. Of the nine macaques that were treated with six doses of Wy-18,185, two had anovulatory cycles associated with premature LH surges and one was devoid of an LH surge. It is possible that the partial anti-ovulatory effectif Wy-18,185 in the monkey may be due to its mildly inherent gonadotropin releasing properties triggering an LH surge at a time when the follicles were incapable of a complete ovulatory response. However, the general lack of effect of the antagonist, coupled with reports on the comparative refractoriness to LH-RH and related agonists, on reproductive parameters in this primate species, in contrast to the rat, rabbit and hamster, indicate that the macaque may be an inappropriate model.

Automatic device for measuring the ‘spinability’ of cervical mucus in woman

The mucus secretion produced by the uterine cervix in the human plays several essential roles in the process of reproduction. It is known that the rheological properties of cervical mucus are subject to variations throughout the ovarian cycle. Indeed, the refractive index, viscosity and stickiness of cervical mucus, as well as its capacity to be drawn out into long threads, change in direct response to the cyclic variations in hormone levels. The latter rheological property, which is different from viscosity, was first known by the German name ‘Spinnbarkeit’, then called ‘spinability’. According to REINER and SCOTT BLAIR (1966), cervical-mucus spinability is an essential parameter in the female reproductive function, owing to its close correlation with a possible fertilisation. Actually, the spinability value is maximal during the ovulatory period when cervical mucus is freely penetrable by sperm cells. During the menses period or luteal phase, a low value of spinability is still demonstrable, corresponding to a very low level of sperm penetrability. This paper describes a device which permits the automatic measurement of cervical mucus spinability with better accuracy than known manual methods.

Cervical mucus in estrous ewes after treatment with estrogen, progestogens and intrauterine devices.

The influence of estradiol, 6-alpha-methyl-17alpha-acetoxyprogesterone (MAP), and a unilaterally placed IUD on cervical mucus production was studied in estrous ewes. The animals received either 60 mg MAP from Days 9 to 21 of the extended estrous cycle, 25 mcg estradiol from Day 9 until estrus, or an IUD. MAP treatment significantly (p less than .05) increased cervical mucus production at estrus compared with the other treatments. However, the percentage of dry matter, chloride concentration, and spinnbarkeit did not markedly vary between groups. The protein content was markedly increased by estradiol. In a 2nd experiment, ewes received intravaginal sponges containing either 60 mg MAP, 30 mg 9-fluro-11beta-17-dihydroxyprogesterone-17-acetate (Cronolone), or 60 mg Cronolone from Day 9 to 21 of the extended estrous cycle. All 3 treatments significantly (p less than .01) increased cervical mucus production at estrus. There was little difference in the measured chemical and physical properties of cervical mucus between controls and treated animals. The increased production of cervical mucus in progesterone-treated animals may account for the reported reduction in the number of sperm in progesterone-treated ewes.