Human sperm quality and lipid content after migration into normal ovulatory human cervical mucus containing low numbers of leukocytes

The aim of this study was to investigate whether a relationship exists between the presence of low numbers of leukocytes in normal ovulatory cervical mucus and sperm quality and lipid content after migration. The percentages of live, motile and morphologically normal spermatozoa, movement parameters assessed by computer-aided sperm analysis （CASA）, and ionophore-induced acrosome reaction measured by flow cytometry were determined before and after migration. High-performance liquid chromatography with ultraviolet detection was used to measure the sperm lipid content, including the various diacyl subspecies. The number of leukocytes found in solubilized mucus samples was counted using a haemocytometric method. Overall, the presence of leukocytes in the cervical mucus samples did not significantly influence sperm motility and morphology, sperm kinematic parameters, or the sperm content in sphingomyelin or cholesterol. In contrast, after migration, the decrease in various sperm diacyls and the level of induced acrosome reaction was significantly less pronounced in mucus samples containing ≥10^4 leukocytes than in mucus samples with no or rare leukocytes whereas the level of induced acrosome reaction was higher. The present data suggest that the low level of leukocytes found in normal ovulatory cervical mucus could influence the process of sperm lipid remodelling/capacitation.

Clinical pregnancy rate of women with unexplained infertility with or without cervical mucus aspiration before intrauterine insemination: A randomized controlled trial

Objective:To detect effect of removing cervical mucus before performing intrauterine insemination(IUI)on pregnancy rate in patients with unexplained infertility.Methods:The randomized controlled trial was conducted in Infertility Division of Department of Obstetrics and Gynaecology of a tertiary care hospital.Totally 80 patients of unexplained infertility were recruited.By computer generated block randomization in block size of 4 and 6,patients were randomly allocated at time of starting ovarian stimulation into the cervical mucus removal group or the non-removal of cervical mucus group before IUI,40 in each group.Ovarian stimulation with clomiphene 100 mg from day 2-6 of menstrual cycle along with human menopausal gonadotropin 150 IU was given alternate day starting from day 7.Follicular monitoring was done and further doses given as per response;trigger was planned when 1-3 follicle reach a diameter of>18 mm.IUI was planned after trigger.IUI was done as per the group allocated.Mucus cleaning was done in the cervical mucus removal group by aspirating mucus with IUI syringe and sterile cotton swab before IUI.The primary outcome was clinical pregnancy rate.Number of difficult IUIs and cycle cancellation due to ovarian hyperstimulation were also noted.Results:IUI was not done in 4 patients due to hyperstimulation.Pregnancies per IUI cycle occurred in 7.9%(3/38)in the cervical mucus removal group and 21.1%(8/38)in the non-removal of cervical mucus group.There was no statistically significant difference in clinical pregnancy rate between two groups(P=0.19).Conclusions:There is a trend towards a lower clinical pregnancy rate with removal of cervical mucus before IUI in women of unexplained infertility though the difference is not statistically significant.Further studies with large sample size need to be done on this intervention.

CYCLIC CHANGES OF LACTATE DEHYDROGENASE IN CERVICAL MUCUS

Lactote dehydrogenase (LDH) in cervicai mucus of thirteen ovulatory women was serially determined and serum LH, FSH, E2, P and cervical mucus score were measured. There was a cyclic change in LDH activity, being high in follicular phase and luteal phase, but increasing significantly in periovulatory phase. In follicular phase, there was a negative correlation between LDH activity and E2 (r=-0. 76, P< 0. 03 ). in luteal phase, there was a positive correlation between LDH activity and P (r=0. 92, P<0. 001). The results suggest that LDH activity in cervical mucus measurment can be used as an index of predicting ovulation.

Level of Copper Ion in Cervical Mucus of Various Duration after Inserting VCu200IUD

The purpose of the study was to test the effective period of VCu200 IUD.The concentration of copper ion was measured with non-flame atomic absorption spectrophotometer HITACHI-180.The average concentration of coPPer ion(x±s.)was 2.66±0.58μg/g cervical mucus wet weight(μg/g·M·W·W) in the first year,then gradually decreasing to 0.91±0.16μg/g·M·W·W in the fifteenth-year group of VCu200 IUD.There was an average of 0.35±0.08～0.56±0.14 μg/g·M·W·W in the control group.It showed that the concentration of copper ion was decreasing with prolongation of use of VCu200 IUD and there was statistically significant difference between VCu200 IUD group,on the one hand,and the stainless steel ring group and the control group(P<0.05～0.01)on the other hand.No difference was found between the stainless steel ring group and the control group(P>0.05).It was reported in the literature that the concentration Of copper ion in 1.0μg/ml had the action of antifertility,and it was found that the concentration of copper ion was higher than 1.0μg/ml in the tenth year after insertion of VCu200 IUD.It suggested that effective period of VCu200 IUD was at least ten years.

Risk Factors for Preterm Delivery in Asymptomatic Singleton Pregnant Women with a Sonographic Short Cervix

Objectives: Although an asymptomatic short cervix is a risk factor for spontaneous preterm birth (SPTB), the risk factors for SPTB among those with short cervix remain unknown. We herein investigated risk factors for preterm delivery (PTD) at <34 weeks of gestation in pregnant women with a short cervix. Methods: This was a retrospective study. Seventy-three asymptomatic pregnant women with a sonographic short cervix (excluding visible bulging fetal membranes) were selected, and the relationship between clinical or biochemical risk factors and preterm delivery (PTD) at <34 weeks was examined. Results: Thirteen cases (17.8%) had PTD at <34 weeks. A univariate analysis showed that a history of SPTD, gestational weeks on admission, cervical length, cervical mucus interleukin (CM-IL)-8 and amniotic fluid interleukin (AF-IL)-8 in PTD at <34 weeks significantly differed from those in delivery at ≥34 weeks (p < 0.05, respectively). A multiple logistic regression analysis identified CM-IL-8 ≥ 803.5 ng/mL [21.3 (3.0 - 260), p = 0.002] and cervical length ≤15 mm [17.1 (1.9 - 517), p = 0.008] as independent risk factors for PTD at <34 weeks. Conclusions: Evaluation for cervical inflammation may be necessary for appropriate treatment strategies in asymptomatic pregnant women with a short cervix. Cervical inflammation warrants further study.