The effect of clomiphene and conjugated oestrogens on cervical mucus

The analysis of 157 menstrual in 50 patients on ovulation-inducing regimens showed that in restoring ovulation clomiphene citrate inhibited cervical mucus production and caused hypersecretion of oestradiol. The inhibitory effect was inversely proportional to serum oestradiol levels, and the addition of conjugated oestrogens did not rectify the inhibitory effect, increase plasma oestradiol levels or increase cycle length. Doubling the clomiphene dosage made no significant difference to any of the parameters examined. The mechanism of this inhibitory effect is still obscure.

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.

Biochemical changes in the cervical mucus of buffalo after induction of oestrus with prostaglandin F-2 alpha and cloprostenol

Prostaglandin F-2 alpha and cloprostenol were given as an i.m. injection on Days 9 or 15 of the cycle. There was a significant decline (P less than 0.01) in the concentration of protein and activities of acid and alkaline phosphatase and peroxidase in cervical mucus after treatments, and the change was more marked in animals that responded by becoming oestrous within 4 days of treatment. Values in control animals remained steady or increased.

Experimental study of cervical blockage induced by continuous low-dose oral progestogens

An investigation correlating scanning electron microscopic observations with sperm penetration tests carried out on cervical mucus under the influence of low-dose continuous progestogen (Norgestrienone) is presented. The results demonstrate that such type of contraceptive is involved in drastic alterations of mid-cycle cervical mucus at the macromolecular level. The meshwork which constitutes the infrastructure of the cervical secretion appears to be greatly tightened as a result of the treatment, thus giving the woof a general appearance typical of cervical mucus in the late luteal phase. The immobilizing effect of such modified mucus on spermatozoa is demonstrated and the duration of effectiveness after the administration of a last pill on the morning of day 13 is determined.

[Epimestrol in the treatment of normoprolactinemic corpus-lutem deficiency (author's transl)]

The treatment of normoprolactinemic corpus-luteum deficiency with epimestrol is reported. This is a frequent cause of infertility. The clinical and hormonal parameters for the diagnosis and follow-up evaluation of the treatment are described. In the present series 10 of 17 patients with primary infertility and normoprolactinemic corpus-luteum deficiency showed a normalization of the luteal phase. Two pregnancies occured following one cycle of treatment with epimestrol at 5 mg. daily from day 3 to day 12 of the cycle. Epimestrol shows no anti-estrogenic properties in contra-distinction to other ovulation stimulating drugs. The quality of the cervical secretion is therefore not impaired by epimestrol. Side effects or ovarian cysts were not observed.

Fertility impairment in females--present status

Various approaches towards the control of fertility in females have been discussed. The salient observations made in the field of reproductive physiology which may generate new leads for the development of agents capable of inhibiting pregnancy, are described. The discussion concerning the oestrogen and progesterone receptors is directed towards designing new antifertility agents. The different areas of fertility control covered in this survey are of importance for basic and applied research.

[Indirect effects of synthetic LHRH on cervical mucus characteristics]

With the intention of establishing the indirect effect of synthetic LHRH on the qualities of cervical secretion, changes in the cervical mucus of 10 patients suffering from eugonadotropic and hypogonadotropic amenorrhoea were evaluated in a 5 day LHRH application in a daily dose of 100 micrograms i. m. Applying LHRH a significant increase of LH and FSH concentrations without evident differences in cervical mucus characteristics was observed. The quality of the cervical mucus was evaluated by arborization, spinnbarkeit, and the "burning phenomenon". In order to exclude to overall cervical unreactiveness, estrogens to LHRH were added in the course of the following five days. The cervical mucus characteristics had considerably improved without any evident change in FSH and LH concentrations. It is supposed that synthetic LHRH in a daily dose of 100 micrograms i. m. within five days does not affect ovarian steroid production in a way that could be reflected one change in the quality of the cervical mucus.

Reproductive problems in the DES-exposed female

The records of 25 diethylstilbestrol-exposed women under treatment for reproductive dysfunction were reviewed. A tendency toward pregnancy wastage (5 of 10 patients), ectopic pregnancy (2 of 8 patients), cervical factor infertility (15 of 20 patients), hysterographic abnormalities (15 of 19 patients), and ovulatory dysfunction (10 of 25 patients) was noted. With the exceptions of ovulation induction and cervical cerclage, no means of treatment can be recommended.

The evolution of cervical mucus infrastructure in normal cyclic baboons (Papio anubis) and castrated females receiving hormonal supplies. A scanning electron microscope study

The scanning electron microscope was used to study the evolution of the infrastructure of cervical mucus in normal cyclic baboons and in castrated animals treated with ovarian hormones for establishing an artificial cycle. In both groups, the results make conspicuous the progressive enlargement of the filamentous woof, which attains a maximum at midcycle and then decreases by degrees in the second part of the cycle. It was shown that the evolution of the framework is very similar during normal and artificial cycle, with only variations of slight amplitude. Moreover, the variations in the baboon mucus infrastructure closely resemble those described in the human. The results are briefly discussed in the light of known data.

Bromelin for liquefaction of cervical mucus in sperm antibody testing: its effect on spermagglutinating immunoglobulin G

Incubation of cervical mucus with the proteolytic enzyme bromelin is known to result in complete liquefaction of the gel. This effect has been used in the detection spermagglutinating antibodies in cervical mucus. However, the well-known papain-like effect of bromelin on human immunoglobulin G (IgG) might be expected to lead to an underestimation of the sperm antibody activity in cervical mucus. This possibility was investigated by studying the effect of bromelin on known amounts of purified IgG from four spermagglutinating sera. Serologic testing of bromelin-treated samples of cervical mucus mixed with purified IgG revealed no effect on spermagglutinin titers, whereas a significant effect was observed on purified IgG alone. Inert proteins in cervical mucus seem to protect the antibodies against degradation, apparently by substrate competition. Liquefaction of cervical mucus by bromelin seems to be a better basis for the assessment of the sperm antibody content of the mucus than extraction procedures, which have been shown to give a deficient yield.

The role of acrosin in sperm penetration through human cervical mucus

Enzymes have been implicated in facilitating cervical mucus penetration by spermatozoa. One of these enzymes in the neutral proteinase acrosin, which is associated with the sperm acrosome. To determine the validity of this hypothesis, human spermatozoa were incubated with the following acrosin inhibitors: p-aminobenzamidine (AB), N-alpha-p-tosyl-L-lysine chloromethyl ketone (TLCK), and p-nitropheyl-p'-guanidino benzoate (NPGB). An in vitro slide test system was developed which allowed inhibitor-treated and control spermatozoa to be evaluated against the same human cervical mucus sample. At inhibitor concentrations far exceeding those necessary for the inhibition of human acrosin, there was no effect on spermatozoal penetration into or through the mucus. These findings indicate that, in man, acrosin activity is neither necessary nor facilitory to sperm penetration of cervical mucus. Evidence is also presented that demonstrates the superiority of the newly developed double-interface slide test, especially for comparative purposes, over the tests currently in use.

Changes in ovine cervical mucus in response to oestrogen treatment

After 10 days pretreatment with 10 mg progesterone daily, ovariectomized ewes were injected i.m. with 12.5, 25, 50 or 100 micrograms oestradiol benzoate (OB) and cervical mucus was collected 16, 24, 32, 40 and 48 h later (Exp. 1), or were injected with 12.5, 40 or 100 micrograms OB daily, and the mucus examined, for 9 days (Exp. 2). The Spinnbarkeit was affected by the dose of OB over 9 days, but at all doses it increased over the first 3 days of treatment (Exp. 2). The wet weight of the mucus, the amount and proportion of water, and therefore the degree of arborization, increased with the dose of OB but decreased after 3 days in Exp. 2. The amount of dry matter, protein or carbohydrate did not have any clear relationship to dose or duration of OB treatment.

[The first three-stage preparation for hormonal contraception. Clinical results (author's transl)]

The controlled clinical trial is reported of a new three-stage oral contraceptive which has meanwhile been introduced on to the market under the trade name Triquilar. Triquilar has a reliable contraceptive action: no pregnancy occurred in 8068 treatment cycles. In spite of the very low doses of estrogen and gestagen--Triquilar contains the lowest total quantity of steroids of all available preparations--the multistage structure guarantees an outstanding cycle control and a particularly good general tolerance. The reasons are discussed which today support the use of an oral contraceptive with the lowest possible amounts of the two hormone components.

Mucociliary transference rate and mucus viscoelasticity dependence on dynamic storage and loss modulus

Various samples of estrous bovine cervical mucus were collected, and their dynamic viscoelastic properties were determined at between 2.7 and 4.4 rad/s. Comparing the loss modulus with the rigidity (storage) modulus for the samples taken, the former was found to increase markedly as the latter increased. Limited exposure of mucus to increased temperatures removed crosslinks, whereas treatment with glutaraldehyde introduced additional ones. In the case of one sample, the number of crosslinks was altered in this way. As the number of crosslinks decreased or increased, the storage modulus decreased or increased, but the loss modulus remained relatively unaffected. The transference (ability to move particle loads) of native and modified samples on the ciliated epithelium of a frog palate depleted of mucus was determined. All data for transference rate correlated against changes in the storage modulus. The rate was maximal for a storage modulus of 1.6 dynes.cm-2 and decreased rather sharply to either side of this value. No such correlation could be found against the loss modulus. In fact, whereas very different values of the loss modulus corresponded to the same storage modulus, the transference rate was the same. Hence, the storage rather than the loss modulus determines transference rate.

Human cervical mucus. V. Oral contraceptives and mucus rheologic properties

Mucus viscoelasticity on individual samples obtained from patients using combination oral contraceptives was quantitated by microrheometry. These results, in conjunction with mucus chemical characterization, indicate that combination oral contraceptive use eliminates the cyclic variations in mucus chemical, physicochemical, and rheologic properties associated with the ovulatory menstrual cycle. A correlation was demonstrated between the mucus elastic modulus and mucus nondialyzable dry weight, and the mucins produced during oral contraceptive therapy were shown to be similar to those recovered from ovulatory donors. Differences in mucus properties were noted when donors using estrogenic contraceptives were contrasted with those using androgenic contraceptives. On the basis of established relationships between sperm penetrability and mucus solids content, it was concluded that the use of contraceptives, as examined in this study, provided a secondary degree of fertility control at the cervical level.

Altered response of cervical and vaginal epithelia to oestradiol benzoate in ewes after prolonged exposure to oestrogenic pasture

Ovariectomized ewes, 10 clover disease infertility and 10 controls, were injected daily for 3 days with 25 micrograms oestradiol benzoate. At the end of this period, the Spinnbarkeit of cervical mucus and the keratinization of the vaginal epithelium were less in the infertile ewes. It is suggested that the infertility in clover-affected ewes is due to an inability of target organs to give a continued response to the 'priming' action of oestrogen.