At the test for compatibility (assay Kushroka) in the conclusion it is specified " 15 20 certificate or act... [Архив]

Kamenetskij B.A.

28.07.2004, 04:20

Interaction of spermatozoons with cervical slime.
Cervical slime promotes migration of spermatozoons during the limited period of a menstrual cycle. The cervical slime sated or saturated by estrogens is favorable for a penetration of spermatozoons. Duration of the favorable period at different women is various. Moreover, this period varies at the same women from one menstrual cycle to another. Hence, ONLY AFTER REPETITION of TESTS In SEVERAL CYCLES it is possible TO MAKE the CONCLUSION About PRESENCE of DISTURBANCE of INTERACTION of SPERMATOZOONS With CERVICAL SLIME.

The test in vitro (the postcoital test)
The postcoital test should be spent probably more close by the moment of the ovulation defined or determined on the basis of clinical criteria (usual duration of a cycle, basal temperature, changes of cervical slime, a cytology of a vagina if it is possible or probable, changes of a level of estrogens in Serum or urine and US of ovaries). It is important, that each laboratory carried out research of cervical slime through a standard time interval after a coitus. This time varies within the limits of from 9 till 24 o'clock.
Instructions for patients on preparation for the postcoital test or dough.
Both of the partner should refrain from the sexual relations before carrying out of the test or dough within at least 2 days
It is impossible to use vaginalnuju greasing during the sexual relations and to be washed away after it or him; it is impossible to take a bath after the sexual relations.

Technics or Technical equipment of carrying out of the test or dough
Into a vagina enter a mirror (without greasing) and tuberkulinovym a syringe (without a needle), a pipette or a polyethylene tube take the sample vydeleny from a back vault of the vagina. Other syringe or a catheter take the sample of slime from the cervical channel. Further each sample put or render on separate subject glass, cover with cover or integumentary glass and investigate or research at standard depth by means of fazovo-a contrast microscope.
Estimation of results
- The sample vydeleny from a vagina
Usually spermatozoons in a vagina perish during 2 h hours. The purpose of research of the sample vydeleny from a vagina - an establishment of the fact of hit of spermatozoons in a vagina.
- The sample of cervical slime
The number of spermatozoons in the bottom part of the cervical channel varies depending on time, last after the sexual relations. In 2 3 hours after a coitus in the bottom part of the cervical channel a plenty of spermatozoons accumulates. For standardization of results it is recommended to measure their quantity or amount in standard edenitsah volume (kol-in spermatozoons in cubic mm), and mobility on following categories: a-fast progress; b - slow and flaccid progress; c - nepostupatelnoe; d - motionless spermatozoons. Presence of ANY number of spermatozoons with fast progress is the most important indicator of normal function of cervical slime.

Interpreting of results
The purpose of the postcoital test or dough is not only definition of number of active spermatozoons in cervical slime, but also the estimation of survival rate and behaviour of spermatozoons later is a lot of hours after the sexual relations. Carrying out of the test or dough in 9 24 hours is optimum for an estimation of viability and survival rate of spermatozoons.
Presence in slime of the cervical channel at this stage of any number of spermatozoons with fast progress is argument against opinion on the important role of the cervical factor, as possible or probable reason of sterility or barrenness, at the given pair (Oei and all., 1995).
At negative or pathological result of its or his postcoital test or dough it is necessary to repeat. If in the cervical channel and a vagina spermatozoons are not found out, whether it is necessary to ask pair really there was an ejaculation and spermatozoons have got in a vagina. The reason of negative result can be wrong time of its or his carrying out. The tests spent too early or too late, can yield negative results and at fertilnyh steam. At some women the test can be positive only 1 2 days during all menstrual cycle. If time of an ovulation to establish or install it is precisely impossible, a little to repeat the test some times during a cycle or to spend tests in vitro. ONLY REPEATEDLY RECEIVED RESULT of the POSTCOITAL TEST or DOUGH During SEVERAL CYCLES UNDER CONDITION OF OPTIMUM TIME of CARRYING out CAN SVIDETELSTVOVAT About the ROLE of the CERVICAL FACTOR, AS POSSIBLE or PROBABLE REASON of STERILITY or BARRENNESS.

Tests in vitro.

Detailed studying of interaction of spermatozoons with cervical slime can be spent and by means of tests of a penetration in vitro. Usually these tests spend in case of reception of negative result of the postcoital test or dough, and they are most informative at two-dimensional testing with use of spermatozoons and cervical slime from donors.
If the purpose of carrying out of the test or dough of interaction of spermatozoons with cervical slime is comparison of quality of various samples of cervical slime it is necessary to use one sample of an ejaculate with optimum characteristics of concentration, mobility and morphology of spermatozoons. If it is necessary to estimate or appreciate quality of various samples of an ejaculate, it is necessary to use the same sample of cervical slime to know about ability of spermatozoons to a penetration of this slime. If at use of an ejaculate of the husband and slime of the wife we have received negative result of the test or dough, it is possible to spend two-dimensional testing with spermatozoons and cervical slime of the donor to define or determine spermatozoons i/or cervical slime are responsible or crucial for patologicheky result. Donor cervical slime can be received from women whom spend an artificial insemination in the middle mentrualnogo a cycle. Cervical slime should be collected before an insemination in a natural cycle or in a cycle of stimulation of an ovulation Gonadotropinums. Women whom spend stimulation of an ovulation by Clomifencitratum, it is not necessary to use as donors of cervical slime in connection with a possible or probable negative effect of antiestrogen on cervical slime.
Tests in vitro spend within an hour after reception of the sample of an ejaculate. To use follows only the cervical slime received from women in the middle of a menstrual cycle. Use of substitute gels, for example, cervical slime from cows or synthetic gels, cannot be recommended as an equivalent of cervical slime of the woman for tests of interaction of spermatozoons with cervical slime in vitro.

Interpreting of results
Spermatozoons penetrate in slime and more than 90 % from them have distinct or clear progressive mobility (normal result)
b) Spermatozoons penetrate in slime, but the majority does not move ahead further, than on 500 micron (t. e. About ten lengths of a spermatozoon) from a surface of contact of an ejaculate with slime (bad result)
Spermatozoons penetrate in slime, but quickly lose mobility or their movements become "oscillatory" (the adverse result specifying presence antispermalnyh of antibodies)
d) the Penetration of spermatozoons in slime does not occur or happen. Phalanxes are not formed or can and be formed, but spermatozoons accumulate along border of contact with cervical slime (adverse result)

For more objective estimation of interaction of spermatozoons with cervical slime exists t. n. Test Kremmera (in capillary tubules) which allows to spend not only qualitative, but also a quantitative estimation (distance of migration, density of a penetration, duration of progress of spermatozoons)
Yours faithfully,
To. M. n. B.Kamenetsky
For consultation i/or carrying out of procedure EKO you can preliminary enter the name to me on reception on bodies: (812 325 92 72; 312 30 65 / Rossijsko-the Finnish Center AVA-PETER Sankt-Petersburg./