[Prediction of ovulation].

Prediction of ovulation was carried out by B-ultrasonography, BBT graph, cervical mucus and appearance of mittelschmerz in 45 normally menstruation women for a total of 72 cycles. LH peak values were also determined in 20 cases (20 cycles). The results were as follows: 1. The relation-ship between each index and ovulation: (1) The ultrasound image of follicle: average daily follicular growth during the 4-5 day before ovulation was 2.5 +/- 2.1 mm (means +/- s). Average diameter of the biggest follicles one day before ovulation was 20.6 +/- 2.0 mm. (2) The change of cervical mucus: the opening of external os and the secretion of mucus with ferning became most typical one day before the ovulation. (3) BBT graph: in a majority of cycles, ovulation occurred at the first day of the initial rise in temperature. (4) Mittelschmerz: occurred in 35% of cycles and appeared within 24 hours before ovulation. (5) LH peak value: ovulation occurred 24 to 48 hours after the first significant rise of LH, and within 24 hours after LH peak value. 2. The relation-ship between indices: in the majority of cases, when we employ the ultrasound image of follicular rupture as a signs of ovulation, LH peak value, follicle of biggest diameter, maximum volume of cervical mucus, the lowest point of BBT and mittelschmerz appear on the same day, namely, one day before ovulation. The authors suggest that ultrasonography used combination with other parameters provides a feasible and relatively accurate and reliable method for the prediction of ovulation in clinical practice.

The predictive value of the postcoital test for auto- and isoimmunity to spermatozoa.

Twenty eight infertile couples with sperm antibodies were used in the study. The immunologic factors in the husbands and wives were compared with the results of the post coital test. The results of the study showed that the post coital test had a predictive value of 75% for male auto-immunity to sperm while only 37% of the females with sperm antibodies had a poor post coital test. It was concluded that the post-coital test is an important screening predictor of auto-immunity to spermatozoa.

A radiolabeled antiglobulin assay to identify human cervical mucus immunoglobulin (Ig) A and IgG antisperm antibodies.

Antisperm immunoglobulin (Ig) A and IgG antibodies in human cervical mucus (CM) were identified by a radiolabeled antiglobulin assay. Cervical mucus samples from fertile and infertile women were exposed to a 1:3,200 dilution of 2-mercaptoethanol (2-ME), and 5 micrograms of the solubilized CM protein were assayed for the presence of IgA and IgG antisperm and anti-Candida activity by the radiolabeled antiglobulin assay. Purified human secretory IgA and IgG exposed to 2-ME retained the molecular integrity and functional activity of the untreated antibody molecules. CM aliquots collected after high-performance liquid chromatography (HPLC) fractionation were assessed for antisperm antibody activity; antisperm antibody activity was retained in the appropriate IgA or IgG CM fractions. The incidence of CM antisperm antibodies was minimally affected when the radiolabeled antiglobulin assay was performed with a motile sperm population. Approximately 70% of the CM IgA antisperm antibodies were of the IgA1 subclass; CM IgG was primarily of the IgG4 subclass. When Candida antigen was substituted for sperm in the radiolabeled antiglobulin assay, the CM antisperm antibodies were found to be exclusively sperm-specific. These data indicate that the radiolabeled antiglobulin assay using 2-ME to extract CM antibodies is a specific method for the assay of antisperm antibodies in CM.

[A new test for detection of amniotic fluid following rupture of the fetal membranes]. / Ein neuer Test zum Fruchtwassernachweis nach Blasensprung.

A new simple test of the identification of ruptured fetus membranes has been studied which is based on the heating of the dry sample slide in which endocervix specimen has been placed. When this specimen contains amniotic fluid, the dry sample slide turns white. When the amniotic fluid doesn't exist, it turns brown. 275 cases of ruptured membranes in term pregnancy have been studied and our test has proved 100% percent successful. We have also studied 225 cases of term pregnancies with unruptured membranes and the rupture of membranes appeared in 24 of the cases. (10.6% false positive results). This new method is simple, fast, economical and reliable in the testing of ruptured membranes with a small percentage of false positive results in cases of unruptured membranes.

[Correlation between indicators of the fertile period of the menstrual cycle and ultrasonically-determined ovulation]. / Correlazione tra indicatori del periodo fertile del ciclo mestruale ed ovulazione ecograficamente determinata.

The authors intend to verify the reliability of some indices set up for the assessment of the fertile period of the menstrual cycle in women. The patterns of the following indices were studied and related to the day of ovulation, as detected by pelvic ultrasonography, in 42 cycles in healty women: the urinary surge of luteinising hormone tested by radioimmunoassay (R.I.A.), urinary surges of estrone-3-glucuronide (E1-3-G) and pregnanediol-3 alpha-glucuronide (Pd-3-alpha-G) tested by chemiluminescence immunoassay, cervical mucus at the vulva and basal body temperature (B.B.T.) recorded by self-observation. The patterns of these parameters have shown a various temporal relationship and reliability for detection of the fertile days of the menstrual cycle.

Cervical mucus prolactin levels in normal fertile and infertile women.

Cervical mucus and serum samples were obtained from 42 anovular women and 20 normal ovular fertile women (controls) for the determination of prolactin concentration by a solid phase radioimmunoassay. The former group was subgrouped into 14 galactorrhoeic (9 with oligohypomenorrhea and 5 with amenorrhea) and 28 non-galactorrhoeic (19 with oligohypomenorrhea and 9 with amenorrhea). The level of prolactin in cervical mucus of normally menstruating women was significantly higher than that of serum at P less than 0.0125 (11.68 +/- 0.77 ng/ml and 16.09 +/- 1.65 ng/ml, mean +/- SE, respectively). Serum prolactin level in galactorrhoeic amenorrhea cases was 8.2 times that of controls, while cervical mucus prolactin amounted to 32 times its control value. The rise of cervical mucus prolactin in cases of galactorrhea oligohypomenorrhea was 21 times its control value which is markedly higher than that of serum (1.9 times). The average rise of serum prolactin in the whole group of galactorrhea with abnormal menstrual function was about 4 times the control value, while the average rise of cervical mucus prolactin was about 41 times the corresponding control value. In the cases of galactorrhea with menstrual dysfunction, serum prolactin level may be normal in 50% of cases, while cervical mucus prolactin is strikingly elevated in 100% of cases. The possibility of pituitary adenoma should be considered if the level of serum or cervical mucus prolactin exceeds 100 ng/ml and 600 ng/ml respectively. The possible physiological role of cervical mucus prolactin and its source are discussed.

A new crystallographic approach to fern-like microstructures in human ovulatory cervical mucus.

A new approach to fern-like structures in dried ovulatory cervical mucus has been carried out. Polarizing microscopy and conventional X-ray devices permitted these well-known structures to be demonstrated as being, both in nature and structure, more complex than previously described. The core of the dendrites appears to be mainly composed of NaCl, but also of KCl. They appear, under the polarizing microscope, as isotropic crystals. Anisotropic structures can be observed either at the periphery of the dendrites or isolated as small spheroliths. Anisotropic structures are insensitive to temperature variations but highly hygroscopic. They become rapidly amorphous when placed at room temperature without caution. The anisotropic period, 7 days long, is inscribed within the ferning period. Maximum anisotropy corresponds to the maximum production of cervical mucus, spinability value and basal body temperature rise. Anisotropic structures may be considered to be characteristic structures occurring spontaneously in ovulatory cervical mucus. These newly described structures consist of sodium or potassium sulphates.

Simple office methods to predict ovulation: the clinical usefulness of a new urine luteinizing hormone kit compared to basal body temperature, cervical mucus and ultrasound.

A new urine luteinizing hormone (LH) kit, First Response (Tambrands Inc., Palmer, MA) was compared with basal body temperature (BBT), cervical mucus scoring and abdominal ultrasound follicular scanning in their ability to predict ovulation to within 2 days of the serum LH peak. BBT was kept daily. From day 10 daily ultrasound scanning and cervical mucus examination were performed and serum oestradiol, luteinizing hormone, follicular stimulating hormone and progesterone were assayed. First Response was significantly more accurate than BBT and cervical mucus when compared in their ability to predict ovulation to within 2 days of the LH peak (p less than 0.05). First Response pinpointed 93% (27/29) of the ovulatory cycles compared to 72% (18/25) and 61% (19/31) for BBT and cervical mucus respectively. It was better but not significantly so against abdominal ultrasound which predicted 77% (24/31). The implications of this finding and the value of the other simple office tests in clinical practice are discussed.

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.

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.

IgG and IgA content of vaginal fluid during the menstrual cycle.

Immunoglobulin levels in cervicovaginal secretions during the menstrual cycle have not been well characterized biochemically. We determined the IgG and IgA concentrations in vaginal fluid obtained by patient self-sampling with an Ovu-Trac aspirator. Vaginal fluid IgG levels were less than 1-270 mg/dL. On the average the levels of IgG were relatively high after menstruation, declined during the ovulatory phase and remained relatively low during most of the luteal phase. The IgA levels were less than 10 mg/dL, and many samples contained IgA at our assay's lower limits of detection (microradial immunodiffusion). The preovulatory and luteal phase levels of IgG and IgA in vaginal fluid were generally lower than those reported for cervical mucus, but the ovulatory phase IgG and IgA composition was comparable between vaginal fluid and cervical mucus.

PIP: The IgG and IgA content of vaginal fluid obtained was determined by daily sampling with the Ovu-Trac vaginal pipet. In addition to vaginal fluid sample volume plots, serum luteinizing hormone and progesterone levels were obtained. IgG and IgA measurements in vaginal fluid throughout the menstrual cycle are reported. A total of 12 cycles from 12 women were studied. In all 12 cycles a significant luteinizing hormone peak was observed. The progesterone levels reached significantly high levels in the 12 cycles, indicating that ovulation presumably had occurred. A peak in vaginal fluid sample volume occurred typically near the luteinizing hormone peak. The IgG and IgA concentrations of the vaginal fluid samples from the 12 cycles were determined. The IgG levels were less than 1-270 mg/dL. There was much fluctuation in vaginal fluid IgG levels throughout the cycle, but a general pattern did emerge. Vaginal fluid IgG levels were relatively high in the postmenstrual/early proliferative phase, with a steady decline to relatively low levels throughout the luteal phase. There was no direct correspondence between the volume of vaginal fluid and the IgG concentration, as seen from a comparison of the average vaginal fluid IgG concentration with the average vaginal fluid sample volume. Vaginal fluid with a low sample volume in the early preovulatory phase had relatively high levels of IgG, whereas that with a low sample volume in the luteal phase had relatively low levels of IgG. IgA in vaginal fluid was present at levels 10-fold less than those of IgG. The IgA concentrations of many of the vaginal fluid samples were near the assay's lower limit of sensitivity, making it difficult to reach any conclusions about cyclic changes. The lowest vaginal fluid IgA concentrations were observed around the middle of the luteal phase.

Prostaglandins E and F in cervical mucus of pregnant women.

Cervical mucus concentrations of prostaglandins E (PGE) and F (PGF) were measured by radioimmunoassay in samples collected from 30 pregnant women. The amount of mucus that could be aspirated did not vary significantly at various stages of gestation and was 67 mg on the average. Concentrations of both prostaglandins were lowest in the first trimester and increased significantly during the second trimester. No significant further increase was observed during the third trimester. Serial samples taken from five women at approximately weekly intervals from the 35th to the 36th week onward did not show any significant increase toward term, although several individual samples had very high concentrations, suggesting that the prostaglandins were secreted into the cervical lumen in pulses. During the first and second trimester, the concentrations of PGE and PGF were similar, but during the third trimester PGF levels were significantly higher. The mean concentrations of PGE and PGF in cervical mucus during the second half of gestation were 10 to 20 times higher than their reported levels in amniotic fluid at the same stage, and in the range reported by others to be effective in modulating cervical tissue responses in vitro. Two to 4 hours after intercourse, prostaglandin concentrations in the cervical mucus were found to be about 10- to 50-fold higher than normal. The prostaglandins in cervical mucus may well participate in the gradual changes in the extracellular matrix of the cervix that result in the extensive remodeling of the cervix during pregnancy.

Oestrus during pregnancy in the cow.

Forty-three oestruses were observed in 35 pregnant cows in one beef suckler herd and 17 dairy herds; at each oestrus the pregnant cow stood willingly to be mounted by another cow or bull. Such oestruses were observed at all stages of pregnancy, although more often between 121 and 240 days, occurred more than once per pregnancy and were also seen in successive pregnancies. On one farm where the dairy cows were observed for four 30 minute periods daily, oestrus was recorded in 5.7 per cent of pregnant cows. The behavioural signs associated with oestrus during pregnancy were indistinguishable from those of true oestrus in non-pregnant animals and although its duration was shorter (mean 5.6 hours), its intensity was comparable to that of the true oestrus. Pregnant cows showing oestrus were usually seen interacting with other oestrous cows in the sexually active group. Pregnant cows showing oestrus had a higher mean condition score (3.9 +/- 0.64) than control pregnant cows (3.0 +/- 0.36). Physiological changes in the genital tract normally associated with true oestrus were not observed in pregnant cows showing oestrus. There was no ovulation or metoestrous bleeding. The characteristics of cervical mucus, including ferning patterns, were similar to those of pregnant cows at the same stage of pregnancy. Hormonal changes associated with oestrus in non-pregnant cows were not observed in the pregnant cows exhibiting oestrus. Seven of nine pregnant cows at oestrus stood willingly to be mounted by a bull. On seven occasions, bulls exposed only to cervical mucus from pregnant cows showing oestrus did not display flehmen.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes in fatty acid composition of cervical mucus lecithin during pregnancy.

The fatty acid composition in cervical mucus was determined in 37 pregnant and 17 nonpregnant women using gas liquid chromatography. In both groups palmitic acid (16:0) and oleic acid (18:1) were the predominant acids comprising more than half of the total amount. Compared to nonpregnant controls, pregnant women had markedly elevated levels of oleic acid (18:1), while mean levels of myristic acid (14:0) and stearic acid (18:0) were significantly lower. These pregnancy-induced changes in fatty acid pattern could not be ascribed to the increased viscosity of cervical mucus. Only minor differences in fatty acid pattern were found between women in first trimester and at term. In contrast to nonpregnant controls, a significant negative correlation between levels of myristic acid (14:0) and docosahexaenoic acid (22:6) was found in pregnant women, indicating a redistribution of these two fatty acids during pregnancy. The present study demonstrates that pregnancy alters the fatty acid composition of cervical mucus lecithin, and that the characteristic changes are present before the 10th gestational week.

[Detection of carcinoembryonic antigen (CEA) in cervico-vaginal irrigation fluids]. / Nachweis des carcinoembryonalen Antigens (CEA) in Zervikovaginalspülflüssigkeiten.

CEA estimations are effected in serum samples and in cervico vaginal fluids (n = 144) of patients with cervical condylomas, cytological undecided and cytological positive findings and in follow up performed histology. 21 healthy women were used as a control group. For taking cervico-vaginal fluids 5 ml isotonic NaCl solution were instilled in the fornix vaginae. After that 5 ml of the solution mixed with cervico vaginal fluids were aspirated. A polyclonal anti-CEA-antiserum was applied to radioimmunoassay. Remarkable high concentrations were found in cervico vaginal fluids compared with serum values. (Table: see text). In cases of cervical condylomas and cervical intraepithelial neoplasia significant increased CEA levels were determined in fluids compared with the control group. These results must be seen in consideration that the local CEA concentrations are scattered over a brand range. Regarding to CEA serum concentrations only slight increased values were found in cases of CIN I/II. (table; see text) Therefore CEA-serum estimations are not a diagnostic tool in CIN. The normal range of 10 micrograms/l was exceeded in only one sample of CIN II.

Analysis of the aqueous phase of human cervical mucus by reversed-phase high-performance liquid chromatography and capillary isotachophoresis.

The aqueous phase of human cervical mucus was analysed by reversed-phase high-performance liquid chromatography (HPLC) and capillary isotachophoresis (ITP). With HPLC, seventeen ultraviolet-absorbing and eight fluorescent components and with ITP five anionic and four cationic components could be determined. The sample pre-treatment consisted of a simple ultrafiltration. Ten samples from fertile women and eleven samples from infertile women were analysed. In six samples from the infertile group higher median concentrations of several components were found. This may be an indication of disturbances in the biochemical processes of the cervical mucus of woman with fertility problems.

The influence of copper intrauterine device on fatty acid composition of cervical mucus lecithin.

Fatty acid composition of lecithin was analysed in midcycle cervical mucus obtained from 19 women using a copper intrauterine device (Cu-IUD) and 16 controls. In both groups, palmitic (16:0) acid was the predominant fatty acid and oleic (18:1) acid the second largest component. In women using a Cu-IUD, levels of myristic (14:0) acid were significantly lower, while levels of linoleic (18:2) and docosahexaenoic (22:6) acid were significantly higher than in controls. These changes in fatty acid composition could not be related to duration of IUD use and were very similar to those observed in women with primary unexplained infertility, suggesting that the Cu-IUD-induced modification of fatty acid pattern in midcycle mucus lecithin may be part of the contraceptive mechanism of action.