Cervical Mucus

What is cervical mucus

Cervical mucus is a biological fluid produced in the cervix of the uterus. It consists of glycoproteins that form a gel enriched with amino acids, carbohydrates, and other substances. The composition of cervical mucus changes throughout the menstrual cycle. During ovulation, when estrogen production increases, cervical mucus is secreted in larger quantities and becomes thinner in consistency, allowing spermatozoa to pass through it, be stored within its environment, and move toward the fallopian tube to meet the egg.

The World Health Organization (WHO) recommends cervical mucus assessment as an essential part of infertility investigation in couples, given that both the quantity and quality of cervical mucus are directly related to sperm viability and their ability to achieve fertilization.

Cervical Mucus Examination and the Postcoital Test (Sims-Huhner Test)

The postcoital test, also known as the Sims-Huhner test, first evaluates the quality of cervical mucus and then the viability of spermatozoa within it. Cervical mucus changes during ovulation, so both cervical mucus assessment and the postcoital test (Sims-Huhner test) are performed on a specific day of the cycle. The procedure is as follows:

1. The wife is examined by her gynecologist to determine the phase of her cycle. The gynecologist decides the appropriate day for cervical mucus testing, usually shortly before ovulation.
2. On the appropriate day, the couple has sexual intercourse.
3. After intercourse, the use of antiseptic products is prohibited.
4. Ten to twelve hours after intercourse, the wife visits her doctor or the laboratory for cervical mucus collection.

The cervical mucus is first evaluated for its characteristics, such as quantity, spinnbarkeit (elasticity), pH (how acidic or alkaline it is), and ferning pattern, which is a distinctive microscopic appearance. Then the number of spermatozoa found in the cervical mucus and their motility in that specific environment are assessed.

This test shows whether there are cervical problems that may prevent spermatozoa from passing through on their way to meet the egg. Such problems include the presence of microorganisms, which alter the local pH, attract pus cells, and immobilize spermatozoa. In addition to microorganisms, antibodies may also be found in the cervix, particularly IgG antibodies. When spermatozoa are exposed to cervical mucus containing antibodies, they develop a characteristic shaking movement instead of their normal motility.

Instructions for Cervical Mucus Testing

1. Abstain from sexual intercourse for two days before the test.
2. Sexual intercourse should take place on the evening before the test, and the examination should ideally be performed 10 to 12 hours after intercourse.
3. The use of antiseptic products is prohibited after sexual intercourse.