Macromolecular properties and polymeric structure of mucus glycoproteins

Mucus glycoproteins (mucins) were isolated from cervical and gastric mucus as well as from chronic bronchitic sputum. The mucus gel was solubilized by slow stirring in 6M-guanidinium chloride supplemented with low-Mr proteinase inhibitors. Subsequent removal of non-mucin proteins and DNA was achieved with isopycnic density-gradient centrifugation. The cervical and the respiratory mucins were of similar size (Mr about 10 X 10(6) and 18 X 10(6)), respectively), whereas the gastric mucins were considerably larger (Mr about 45 X 10(6)). 'Subunits' isolated after disulphide bond cleavage were the same size for the three mucins, as were glycopeptides obtained after subsequent trypsin digestion of the subunits. Physical data suggest that the respiratory and gastric mucins conform to the model for the polymeric structure proposed previously for cervical mucins. The macromolecules are described as linear flexible chains behaving, in dilute solution, as random coils. We propose that mucus glycoproteins are considerably larger than hitherto recognized and that mucins of various origins are very similar in their macromolecular properties and polymeric structure.

[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]

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]

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.

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.

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.

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.

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.

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)

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.

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.

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.

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.

Ovine trophoblast protein-1 and bovine trophoblast protein-1 are present as specific components of uterine flushings of pregnant ewes and cows

A rabbit antiserum raised against ovine trophoblast protein-1 (oTP-1) was used to stain Western blots of the protein components from the uterine flushings of pregnant ewes (n = 61), non-bred cyclic ewes (n = 22), bred-but-nonpregnant ewes (n = 36), pregnant cows (n = 34), and bred-but-nonpregnant cows (n = 15). Nonpregnant animals were defined as ones from which no embryo was recovered. Uterine flushings of pregnant ewes contained oTP-1 between Days 14 and 24 of pregnancy, but not at Day 12. All of the cyclic ewes and 34 of 36 bred ewes, judged as nonpregnant, tested negatively for the presence of oTP-1. With one exception, oTP-1 was not detected in the nongravid uterine horns of pregnant ewes in which the conceptus had been confined to one uterine horn. Bovine trophoblast protein-1 (bTP-1), which cross-reacts immunologically with oTP-1, was also detectable specifically in the uterine flushings of pregnant cows when anti-oTP-1 antiserum was used. The urine (n = 14) and certival mucus (n = 20) samples of all the pregnant ewes tested were free of any detectable oTP-1. Thus, a useful pregnancy test for ewes based on oTP-1 release into these fluids seems unlikely. Results of this study show that oTP-1 and bTP-1 are pregnancy-specific proteins that are secreted into the uterine lumen where they possibly exert a local response.

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.

Prediction and self-prediction of ovulation in clomiphene citrate-treated patients

We studied 15 infertile patients for a total of 25 cycles in order to compare the predictive value of the following parameters in timing ovulation: basal body temperature (BBT), cervical mucus, serum E2 and LH, follicular growth as shown by ultrasonography, and urinary LH. The patients themselves tested urinary LH at home using Clearplan kits. BBT had low value as a predictive test for the time of ovulation, whereas ultrasonography had a predictive value of 9%, serum E2 50%, cervical mucus 59%, serum LH 63.6% and Clearplan kits 63.6%. The best predictive reliability in timing ovulation was obtained by considering both serum LH and E2 measurements. The Clearplan kits were as reliable as serum LH measurements and have greater practical advantages.

Structure of human cervical mucus from light scattering measurements

Using laser light scattering, photon correlation and spectral analysis, it was shown that cervical mucus is a non-Newtonian Hydrogel with large meshes (approximately 5 microns). The experimental results are in agreement with a model of hydrogel with weak linkages and are definitely not compatible with a model of entangled macromolecules. Large oscillations, induced by both thermal and mechanical excitation, have been observed in this medium, probably due to its non-Newtonian character.

Therapeutic donor insemination: the impact of insemination timing with the aid of a urinary luteinizing hormone immunoassay

The records of 120 patients undergoing therapeutic donor insemination were reviewed to determine if the use of the enzyme immunoassay of urinary luteinizing hormone (LH) to plan inseminations decreased the number of cycles required to achieve conception. All inseminations were performed with fresh semen. Patients in group 1 (n = 26) utilized urinary LH testing in addition to basal body temperature (BBT) and cervical mucus examinations to time their inseminations, while inseminations in group 2 (n = 94) were timed with only BBT and cervical mucus examinations. The monthly fecundability of patients in group 1 was 0.13, whereas the monthly fecundability of patients in group 2 was 0.11. The mean number of inseminations was 1.4 and 1.6 per cycle for groups 1 and 2, respectively. There were no significant differences between groups 1 and 2 in regard to the number of cycles required to achieve conception. The use of a urinary LH immunoassay for insemination timing offers no benefit over conventional methods of timing (BBT, cervical mucus) when fresh donor semen is used.

Quantitation and localization of cellular retinol-binding protein in squamous-cell carcinomas of the cervix uteri and of the oral cavity

The concentration of cellular retinol-binding protein (CRBP) was determined by radioimmunoassay in biopsies of normal mucosa and squamous-cell carcinomas of cervix uteri from 30 women. The tumour tissues contained significantly higher concentrations of CRBP (median = 120 micrograms/g protein) than normal mucosa (median = 32 micrograms/g protein). The distribution of CRBP in normal mucosa and squamous-cell carcinomas from cervix uteri and from oral cavity was evaluated by immunohistochemical techniques. In tissue sections of normal epithelium from the cervix uteri and the oral cavity, the maturing keratinocytes in the prickle-cell layers were moderately or strongly stained when antiserum against CRBP was used, while the proliferating cells in the basal-cell layer were stained only lightly if at all. Squamous-cell carcinomas of the cervix uteri and the oral cavity presented much the same picture. The observed difference in CRBP concentration between squamous-cell carcinomas and normal squamous-cell mucosa may therefore be more quantitative than qualitative.

Smoking and cervical intraepithelial neoplasia: nicotine and cotinine in serum and cervical mucus in smokers and nonsmokers

A blood sample before treatment was taken from 35 women with cervical intraepithelial neoplasia. Levels of nicotine and cotinine were analyzed by radioimmunoassay. Both cotinine and, especially, nicotine were shown to be strongly concentrated in cervical mucus compared with serum levels. These findings confirm the association shown in epidemiologic studies of smoking and cervical neoplasia. It cannot be concluded that smoking is a genuine cause of cervical neoplasia. However, the results support the concept that smoking is a true risk factor in cervical neoplasia.

Changes in cervical mucus after diathermocoagulation of the cervix

We have studied the principal chemophysical properties of cervical mucus obtained before and after diathermocoagulation (DTC) in 35 patients participating in a program for prevention of cervical carcinoma. Two months after DTC there were significant decreases in the cervical scores for both exo- and endo-cervical mucus (Moghissi scale). Twelve patients with favorable pre-DTC scores, whose condition had deteriorated 2 months subsequent to treatment, again displayed normal scores in both sites 1 year after DTC. We feel, therefore, that DTC does not cause any permanent change in the chemophysical properties of the cervical mucus, but instead only temporary deterioration during the repair phase.

Evaluation of the infertile couple

Evaluation of the infertile couple involves confirming the diagnosis of infertility based on history and a review of coital practices. A complete examination should include the following components: general evaluation, history, physical examination, assessment of ovulatory factor, tubal factor, peritoneal factors, uterine factors, and cervical factor, and assessment of male factor.

Preliminary observations on lactoferrin secretion in human vaginal mucus: variation during the menstrual cycle, evidence of hormonal regulation, and implications for infection with Neisseria gonorrhoeae

The concentration of the iron-binding protein lactoferrin was measured in vaginal mucus of women throughout the menstrual cycle. Lactoferrin is proposed to limit growth of mucosal pathogens such as Neisseria gonorrhoeae. Lactoferrin concentration in mucus was highest just after menses (62.9 to 218 micrograms/mg of protein) and lowest (3.8 to 11.4 micrograms/mg of protein) just before menses. Overall concentration of mucus protein showed no variation with menstrual cycle, and little lactoferrin was detectable in cell debris. Plasma lactoferrin did not show the variation seen in vaginal mucus. Because of the suggestion of hormonal influence on vaginal lactoferrin, its concentration was determined in women receiving oral contraceptive therapy. Mean lactoferrin concentration in women taking oral contraceptives was significantly lower than in the control group (never exceeding 19.8 micrograms/mg of protein) and showed no monthly variation. Vaginal lactoferrin appears to be under hormonal control. Variation in vaginal lactoferrin concentration may result in alterations in susceptibility to bacterial pathogens such as Neisseriae gonorrhoeae.

Structural studies of sialylated oligosaccharides of human midcycle cervical mucin

It was previously shown that reductive alkali treatment of purified human cervical mucin releases a heterogeneous population of reduced neutral, sialylated, and sulfated oligosaccharides (Yurewicz, E. C., and Moghissi, K. S. (1981) J. Biol. Chem. 256, 11895-11904). Four major sialylated oligosaccharide fractions were isolated with approximate compositions of Fuc:GlcNac:Gal:NeuAc:N-acetylgalactosaminitol (GalNAcol) = 0:0:0:1:1 (B1a), 0:0:1:1:1 (B2b), 0:1:2:1:1 (B3a), and 1:1:2:1:1 (B4a), where Fuc is fucose. They comprised roughly 3, 11, 7, and 6% of recovered oligosaccharide chains, respectively. On the basis of periodate oxidations, methylation analyses, and sequential degradations with glycosidases, the following structures were determined. (Formula: see text) Oligosaccharides 1 and 2 are characterized by the presence of N-acetylneuraminic acid in alpha 2,6-linkage to N-acetylgalactosaminitol. The remaining oligosaccharides contain N-acetylneuraminic acid in alpha 2,3-linkage to galactose residues. Oligosaccharides 3 and 4 and oligosaccharides 5 and 6 were isolated as unresolved isomeric mixtures in fractions B3a and B4a, respectively. Oligosaccharides 3 and 4 were distinguished on the basis of susceptibility to digestion with Aspergillus niger beta-galactosidase whereas oligosaccharides 5 and 6 were distinguished on the basis of differential rates of digestion with beef kidney alpha-fucosidase. The structural data indicate the presence of at least two sialyltransferases in human cervical epithelium and further suggest a potential physiologically significant competition between sialyltransferase and beta-N-acetylglucosaminyltransferase for C-6 of the N-acetylgalactosamine residue O-glycosidically linked to serine/threonine of the polypeptide core.

Evaluation of "Determine; The OvuTest" as a device for identifying optimal time for conception

The device known as "Determine; The OvuTest" (Ventco Medical Trading Company, Montreal, Quebec, Canada) was appraised for its stated function of determining the optimal time for human conception by detecting the presence of the protein, uteroglobin (UTG), in cervical mucus. Twenty volunteers used the device daily through three cycles in which ovulation was indicated by rise in basal body temperature and/or elevated levels of luteinizing hormone. No correlation was found between the instrument readings and time of ovulation. When tested in vitro, it did not distinguish the presence of UTG. When vaginal flushings, containing cervical mucus, were analyzed for UTG by double immunodiffusion, no lines of precipitation were observed. We conclude that "Determine; The OvuTest" does not identify the approximate time of ovulation and therefore is not a reliable aid to conception. It does not detect UTG, and periovulation cervical mucus does not contain UTG.

Structure of acidic oligosaccharides isolated from pronase-treated glycoprotein of bonnet-monkey (Macaca radiata) cervical mucus

The major glycoprotein component of cervical mucus of bonnet monkey was treated with Pronase, and the enzyme-resistant glycoprotein purified by gel filtration on Sepharose 4B followed by DEAE-cellulose chromatography. Alkaline-borohydride cleavage of the carbohydrate chains gave a mixture of neutral and acidic oligosaccharides. Seven acidic oligosaccharides were characterized by chemical and enzymic procedures; their proposed structures are: alpha NeuAc(2----3)-[beta GalNAc(1----4)]beta Gal(1----4)GlcNAc(1----6)[alpha Fuc(1----2)beta Gal(1----3)]GalNAc-ol; alpha Fuc(1----2)beta Gal(1----3)/6)[alpha NeuAc(2----3)beta Gal(1----4)GlcNAc(1----3)/6)]GalNAc-ol; alpha GalNAc(1----3)beta Gal(1----3)[alpha NeuAc(2----3)beta Gal(1----4)GlcNAc(1----6)]GalNAc-ol; beta GlcNAc(1----3)[alpha Fuc(1----2)]beta Gal(1----3)[alpha NeuAc(2----6)]GalNAc-ol; beta Gal(1----3)-[alpha NeuAc(2----6)]GalNAc-ol; alpha NeuAc(2----6)GalNAc-ol; and beta Gal3SO3(1----4) GlcNAc(1----6)[alpha Fuc(1----2)beta Gal(1----3)]GalNAc-ol.

Potential role of pregnancy-associated plasma protein-A in human reproduction

By radioimmunoassay, pregnancy-associated plasma protein-A (PAPP-A) was undetectable in matched follicular and luteal phase serum samples (n = 17) or in the peripheral circulation of normal males (n = 17). However, seminal plasma (91.5%), cervical mucus (100%) and pre-ovulatory follicular fluid (99.6%) were consistently PaPP-A positive. In addition to PAPP-A, four circulating protease inhibitors (PIs) were detected in pooled seminal plasma whereas pooled follicular fluid contained an additional six. Follicular concentrations of serum PIs were inversely related to molecular size. By contrast, PAPP-A formed a positive concentration gradient across the blood-reproductive tract barrier suggesting PAPP-A production within the reproductive tract. A minor proportion (1.7%) of ejaculated spermatozoa were coated with PAPP-A, as demonstrated by direct immunofluorescence. Since PAPP-A specifically inhibits leucocyte elastase, it is suggested that PAPP-A coated spermatozoa were "selected" to overcome localized phagocytic-proteolytic degradation. The physiological significance of these findings are discussed in relation to human reproduction.

Copper-containing IUDs are not associated with an increase of malondialdehyde levels in cervical mucus

The malondialdehyde (MDA) content of cervical mucus from 23 healthy adult females was measured using an ion-pairing HPLC method capable of detecting 10 pmol MDA. Ten of the women were wearing copper IUDs, four were wearing plastic IUDs, and nine controls were not wearing an IUD. Cervical mucus was sampled during the follicular, periovulatory, luteal, and menstrual phases. The study was designed to determine if there is a relationship between MDA formation and the use of a copper IUD. A total of 79 samples were analyzed. Only 16 of the samples had sufficient MDA for reliable quantitation with the level ranging from 0.1 nmol/g to 2.32 nmol/g. In 19 of the samples, trace levels (less than 0.06 nmol/g) were detected but could not be reliably quantitated. In the remaining 44 samples, no MDA was detectable. There was no correlation between the presence of copper- or non-copper-containing IUDs and the level of MDA. These results are contrary to a previously published report that used a less specific method for MDA analysis.

Cervical mucus changes and ovulation prediction and detection

Cervical mucus can be used to predict ovulation if a woman has received adequate education in the method and is committed to careful observation of her cervical mucus changes. Many different tests have been based on the quantity, physical properties or biochemical constituents of cervical mucus. However, routine use of cervical mucus for ovulation monitoring by patients requires that the tests be more practical for accurate sample collection and more objective for the detection of cervical mucus changes.

Prolactin in human cervical mucus

The pattern of change in the levels of prolactin (PRL) in cervical mucus was studied in 19 normal ovulatory women. The concentration of PRL in cervical mucus was generally higher than that in plasma except at midcycle, when a reverse relationship was observed. The concentration of PRL in mucus obtained at midcycle was lower than mucus obtained during follicular phase or luteal phase. There were no significant differences in the total PRL content among preovulatory, midcycle and postovulatory cervical mucus samples. The amount of cervical mucus markedly increased during the periovulatory period (two days from the peak of plasma luteinizing hormone). The cervical mucus PRL level undergoes cyclic changes during the normal menstrual cycle, and the decrease in PRL concentration in mucus at midcycle is most likely a result of the dilutional effect of increased mucus volume. The physiological implication of the presence of PRL in human cervical mucus is also discussed.

Mutagenic mucus in the cervix of smokers

A pilot study was conducted to determine whether any relationship exists between mutagenicity of a women's uterine cervical mucus and her current smoking status. Cervical fluids obtained from 78 premenopausal women seen between July 1983 and March 1984 at the University of California, San Francisco Dysplasia (and diethylstilbestrol) Clinic or in a private practice were tested for mutagenicity by means of the Ames-Salmonella microsomal test. Of 36 current smokers, 14 (39%) had positive tests as compared to 5 of 42 nonsmokers (12%). The odds ratio (OR) estimate was 4.7 with 95% confidence limits (CL) of 1.6-14.2. Secretions from 14 of 32 (44%) women who had smoked during the day of the sample collection--within the previous 7 hours--were positive on the laboratory test, whereas none of the 4 women was positive who had smoked 8 hours or more before the specimens were obtained. Fluids from women with dysplasia or carcinoma in situ were more likely to be mutagenic than were those from other women, although this finding may be due to chance (OR = 2.0 with 95% CL of .70-5.9). This relationship between smoking and mutagenic cervical fluids offers evidence that might help to explain the association between cervical cancer and cigarette smoking noted in previous epidemiologic studies.

The pH of cervical mucus, quality of semen, and outcome of the post-coital test

In preliminary experiments, pH measurements were made with pH paper and with a pH electrode on cervical mucus in situ and after aspiration. Paper and electrode gave comparable results with aspirated mucus. Measurements made on mucus in situ and then after aspiration were concordant only when pH paper, but not the pH electrode, was used to measure pH in situ. All spermatozoa were immotile in the post-coital test when the pH of the mucus was below 6. A pH below 6 was found in 38% (23 out of 61) of post-coital tests in which there were fewer than 1% of motile spermatozoa (19% of all tests). The male partners of women who had a mucus pH greater than 6 but had less than 1% of spermatozoa motile in the post-coital test, had slightly poorer quality semen than the partners of women with mucus pH less than 6, or in which there were motile spermatozoa in the mucus.

The tumor marker CA 125 is a common constituent of normal cervical mucus

The presence of the tumor marker CA 125 was studied in the cervices of healthy women. Immunohistochemical staining of normal cervical tissue demonstrated the presence of CA 125 in the tall columnar cells of the endocervical epithelium but not in the ectocervical squamous epithelium. We measured very high levels of CA 125 in liquefied cervical mucus from women with regular menstrual cycles. At midcycle, levels ranged from 14,200 to 153,000 U/ml (n = 13) in cervical mucus, while normal levels less than 35 U/ml were found in the corresponding serum samples. Levels of CA 125 in cervical mucus are comparable to the high levels found in cyst fluids from ovarian tumors (median 24,600 U/ml, n = 25). When secretion of cervical mucus was stimulated by ethinyl estradiol, equally high levels were found (7900 to 138,000 U/ml, n = 10). We conclude that the tumor marker CA 125 is synthesized and secreted by normal endocervical cells. Apparently an effective barrier exists between the endocervical mucosa and the circulation.

Structure of sialyloligosaccharides isolated from bonnet monkey (Macaca radiata) cervical mucus glycoproteins exhibiting multiple blood group activities

Mucin glycoproteins purified from cervical epithelial secretion of the bonnet monkey (Macaca radiata) exhibit multiple blood group activities. Alkaline borohydride reductive cleavage resulted in a mixture of neutral and acidic oligosaccharide-alditols. By high-performance liquid chromatography, seven oligosaccharides (A-4-1 to A-4-7) have been purified from the monosialyloligosaccharide fraction (A-4). Based on the results of 500-MHz 1H NMR spectroscopy, in conjunction with sugar analysis and immunological assays, we propose the following structures for these oligosaccharides. (formula: see text) These structures imply that either the A, B, or H determinant may be found in combination with the Cad/Sda determinant; the oligosaccharides identified, together, account for the blood group activities exhibited by the cervical mucus.

Quantitation of human cervical mucin during consecutive days and hourly during one day at midcycle

Cervical mucin was quantitated in individual samples collected daily during midcycle in 14 normally menstruating women. Quantitation was performed with a recently developed lectin-mediated light scattering (nephelometry) method after separation of soluble proteins from the mucin. Furthermore, mucin was quantitated in individual samples in another group of 12 women from whom cervical secretion samples had been collected hourly from 8.00 to 12.00 a.m. There were significant differences between cycle days (p less than 0.05; two-way analysis of variance) for total amounts of mucin secreted and for mucin concentrations. But during repeated sample collection, only the total amounts of mucin secreted and not the concentrations were affected. From trend analysis data it could be concluded that both mucin contents and water contents increased at midcycle.

Studies on the nature of prolactin-like immunoreactivity in bromelin-treated cervical mucus

Prolactin has been reported to be present in cervical mucus at concentrations higher than those found in blood. Our initial findings appeared to confirm this and the material fulfilled criteria of validity generally applied when an immunoassay is employed on a new biological matrix, i.e. parallelism and chromatographic identity. Further experiments demonstrated that prolactin concentrations in cervical mucus were less than 40 mU/L and the prolactin-like immunoreactivity originally detected was due to the action of the enzyme bromelin which was used to liquefy the mucus. Bromelin has a similar molecular weight to prolactin and appeared to digest prolactin tracer and reduce its ability to bind antiserum in a manner paralleling the effect of adding pituitary prolactin.

Concentration of D-propranolol in cervico-vaginal mucus: targeting of a novel spermicide

It may be possible to develop new contraceptives that can be administered by mouth and will exert their effects after concentration in cervico-vaginal mucus. D-Propranolol was administered in 80 mg doses by mouth to six healthy female volunteers. Samples of blood plasma and cervico-vaginal mucus were obtained before and on six occasions up to 24 hours after drug ingestion. D-Propranolol was concentrated in cervico-vaginal mucus. No changes in blood pressure, pulse, or forced expiratory peak flow (FEPF) were observed.

Late infertile days in early postpartum cycles

Luteal phase abnormalities in early menstrual cycles after pregnancy have been shown to cause confusion in the practice of natural family planning (NFP) for some patients and to restrict severely the number of late infertile days available to others. The cause of the abnormalities is uncertain but appears to be related to the nursing status of the patient.