Improvement of cervical mucus viscoelasticity and sperm penetration with sodium bicarbonate douching

Everhardt, E.; Dony, J.M.J.; Jansen, HB; Lemmens, W.A.J.G.; Doesburg, W.H.

doi:10.1093/oxfordjournals.humrep.a137056

Cited by 13 publications

(7 citation statements)

References 9 publications

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“…Bicarbonate has also been shown to be critical for improving mucus viscoelastic properties (Everhardt et al 1990), and our results here demonstrate its importance for normal mucin release. Specifically, a loss of bicarbonate secretion may underlie an absence of cyclical cervical mucus thinning in CF women at ovulation.…”

Section: Discussionsupporting

confidence: 72%

“…It is noteworthy that these results are not tissue specific and that similar results were recently reported in the small intestine (Garcia et al 2009). HCO 3 − in the reproductive tract appears to thin mucus (Ansari et al 1980; Everhardt et al 1990) and in CF the loss of HCO 3 − secretion appears to coincide with abnormally thick mucus in affected organs. Together, these observations implicate a crucial role for HCO 3 − in releasing gel forming mucins in general, but how?…”

Section: Discussionmentioning

confidence: 99%

“…Bicarbonate douching is reported to improve cervical mucus viscoelasticity and improve sperm penetration (Ansari et al 1980; Everhardt et al 1990), and this suggests that HCO 3 − itself may have an important influence on the properties of mucus. The abnormalities of generalized thick mucus and defects in HCO 3 − secretion in the genetic disease cystic fibrosis (CF) also suggest that HCO 3 − may be a critical determinant of mucus properties.…”

Section: Introductionmentioning

confidence: 99%

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A new role for bicarbonate secretion in cervico‐uterine mucus release

Muchekehu

Quinton

2010

The Journal of Physiology

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Cervical mucus thinning and release during the female reproductive cycle is thought to rely mainly on fluid secretion. However, we now find that mucus released from the murine reproductive tract critically depends upon concurrent bicarbonate (HCO 3 − ) secretion. Prostaglandin E 2 (PGE 2 )-and carbachol-stimulated mucus release was severely inhibited in the absence of serosal HCO 3 − , HCO 3 − transport, or functional cystic fibrosis transmembrane conductance regulator (CFTR). In contrast to mucus release, PGE 2 -and carbachol-stimulated fluid secretion was not dependent on bicarbonate or on CFTR, but was completely blocked by niflumic acid. We found stimulated mucus release was severely impaired in the cystic fibrosis F508 reproductive tract, even though stimulated fluid secretion was preserved. Thus, CFTR mutations and/or poor bicarbonate secretion may be associated with reduced female fertility associated with abnormal mucus and specifically, may account for the increased viscosity and lack of cyclical changes in cervical mucus long noted in women with cystic fibrosis.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A new role for bicarbonate secretion in cervico‐uterine mucus release

Muchekehu

Quinton

2010

The Journal of Physiology

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“…Several studies have shown a significant increase in PCT and in conception rates with the use of a vaginal douche with bicarbonate in previously selected couples (4,(17)(18)(19).…”

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confidence: 99%

In situ variation of cervical mucus pH during exposure to atmospheric air

Correa¹,

Mattos²,

Ferrari³

2001

Braz J Med Biol Res

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The objective of the present study was to determine if exposure of cervical mucus to air during specular examination could modify mucus pH. Detection of changes is justified because of their possible interference with sperm-mucus interaction, since an acidic pH is unfavorable to sperm penetration and is associated with infertility due to the cervical factor. Twenty women with good quality mucus were evaluated. pH measurements of ecto-and endocervical mucus were made in situ using a glass electrode after 0-, 5-and 10-min exposure to air. There was a progressive alkalinization of mucus pH. Mean values of ectocervical mucus pH were 6.91, 7.16 and 7.27, while mean values of endocervical mucus pH were 7.09, 7.34 and 7.46 at 0, 5 and 10 min, respectively. Significant differences were found between the mean values obtained at 0 and 5 min, and at 0 and 10 min (P<0.05), whereas the differences in mean values at 5 and 10 min were not significant at either site. We conclude that 5 to 10 min of exposure to atmospheric air affects cervical mucus pH in a significant way. Since tests used to evaluate sperm-mucus interaction generally have not considered this possibility, we suggest that they should be performed immediately after mucus collection in order to avoid misinterpretation of the results. Abnormalities of the cervix and its secretion are reported to be responsible for infertility in approximately 5 to 10% of women (1). Evaluation of sperm-cervical mucus interaction is important in infertility investigation. The traditional method for the evaluation of sperm-cervical mucus interaction in vivo is the postcoital test (PCT), but in vitro cervical mucus-sperm penetration tests are also used (2,3).Sometimes, negative or abnormal PCT are attributed to immunological problems in particular. Anyway, recent studies have shown that the incidence of immunological factors in these cases is low, and that 80% of them can be reversed by means of a bicarbonate douche (4). The improvement observed with mucus alkalinization suggests that the low mucus pH (5) causes the poor spermmucus interaction. In addition, it was reported that some cases of negative PCT (absence of progressive sperm) or absent PCT (absence of sperm) involving ovulatory mucus and normal sperm became normal during the performance of in vitro cervical mucussperm penetration tests (6,7). It was suspected that this alteration occurred due to the variation of mucus pH after exposure to air.Previous studies have reported pH variation of mucus exposed to air (8,9), but those

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“…Conjugated estrogens (0.625 mg) given daily 8 -9 days prior to ovulation also have been used to improve cervical mucus production (9). If the cervical mucus pH is less than 6, a precoital douche of 1 tablespoon of sodium bicarbonate:1 quart of water has been shown to be effective in some situations (29). Intrauterine insemination is a method that bypasses the cervical mucus by directly depositing the sperm into the uterus.…”

Section: Cervical Factorsmentioning

confidence: 99%