Similar to blocked fallopian tubes pregnancy cannot occur, if there are cervical mucus abnormalities, which functions as a rigid block within the cervical canal that sperm cannot penetrate.
Normally this mucous has a complex chemistry, which is modulated by hormonal changes throughout the cycle. The purpose of the mucus block is to keep vaginal bacteria outside of the cervical canal and the uterine cavity.
However, at the end of the first part of the menstrual cycle (thanks to en.wikipedia.org for this link) following menstruation there is a predominant higher influence of estrogens. This changes the physical attributes around mid cycle to allow the now more fluid mucus in the cervical canal to be specifically penetrated by sperm, which has the right biochemistry to dissolve the mucus. The function of this mechanism is like “a lock and key” and for some couples there are biochemical incompatibility problems in this area.
In infertility clinics the gynecologist will often obtain a mucus sample during the mid cycle time of the woman and about 3 to 6 hours after intercourse. This sample can be tested in a number of ways. Essentially, it shows whether sperm is present or not, what viscosity the mucus has and other qualities (“spinnbarkeit” and “ferning test” are just a few technical buzz words to describe this). In about 5 to 10% of such infertility clinic work-ups clotting of sperm and cervical mucus (called “agglutination”) can be seen under the microscope, which may be due to sperm-antibodies in the woman’s cervical mucus (Ref. 5).
Ref.6 shows that there is an excellent association between two blood tests and this microscopic agglutination test and that this testing showed rates of approximately 20% positive patients in their fertility clinic. They also reported some success with reproductive technology (also called “assisted reproduction technologies” (=ART) where women could be fertilized with their husband’s semen to bypass the cervical mucus abnormality doing in vitro fertilization. Also, anti-sperm antibodies can be found in males who had a vasectomy in the past, then had a vasectomy reversal and are now attempting to father a child. More research is needed in this relatively new immunological reproduction technology field.
1. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 235.
2. B. Sears: “Zone perfect meals in minutes”. Regan Books, Harper Collins, 1997.
3. Ryan: Kistner’s Gynecology & Women’s Health, 7th ed.,1999 Mosby, Inc.
4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 245.
5. AB Diekman et al. Am J Reprod Immunol 2000 Mar; 43(3): 134-143.
6. V Damianova et al. Akush Ginekol (Sofia) 1999; 38(2): 31-33.
7. Townsend: Sabiston Textbook of Surgery,16th ed.,2001, W. B. Saunders Company
8. Cotran: Robbins Pathologic Basis of Disease, 6th ed., 1999 W. B. Saunders Company
9. Rakel: Conn’s Current Therapy 2001, 53rd ed., W. B. Saunders Co.
10. Ruddy: Kelley’s Textbook of Rheumatology, 6th ed.,2001 W. B. Saunders Company
11. EC Janowsky et al. N Engl J Med Mar-2000; 342(11): 781-790.
12. Wilson: Williams Textbook of Endocrinology, 9th ed.,1998 W. B. Saunders Company
13. KS Pena et al. Am Fam Physician 2001; 63(9): 1763-1770.
14. LM Apantaku Am Fam Physician Aug 2000; 62(3): 596-602.
15. Noble: Textbook of Primary Care Medicine, 3rd ed., 2001 Mosby, Inc.
16. Goroll: Primary Care Medicine, 4th ed.,2000 Lippincott Williams & Wilkins
17. St. Paul’s Hosp. Contin. Educ. Conf. Nov. 2001,Vancouver/BC
18. Gabbe: Obstetrics – Normal and Problem Pregnancies, 3rd ed., 1996 Churchill Livingstone, Inc.
19. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 251.
20. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 250.
21. Ignaz P Semmelweiss: “Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers” (“Etiology, the Understanding and Prophylaxis of Childbed Fever”). Vienna (Austria), 1861.
22. Rosen: Emergency Medicine: Concepts and Clinical Practice, 4th ed., 1998 Mosby-Year Book, Inc.
23. Mandell: Principles and Practice of Infectious Diseases, 5th ed., 2000 Churchill Livingstone, Inc.
24. Horner NK et al. J Am Diet Assoc Nov-2000; 100(11): 1368-1380.
25. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
26. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier