Hostile cervical mucus
IT has always seemed like the formula – sperm aided by semen plus fertilisation of an egg – equals pregnancy. And while at face value this is correct, Dr Shantell Neely-James, consultant obstetrician-gynaecologist at Trade Medical, Portmore, says that a woman’s body can sometimes be a less than ideal environment for sperm, noting that even the cervical mucus protecting the sperm on its arduous journey to the egg can be counterproductive.
“Cervical mucus functions in sperm transport and protection during the fertile window to increase the chances of fertility, and when it malfunctions, it then decreases fertility potential and may be a major cause of infertility in some couples who have been trying to conceive,” Dr Neely-James advised.
She explained that the cervical mucus is a jellylike fluid secreted by the glands of the cervix. It ranges in volume and consistency throughout the menstrual cycle and is usually thin and low just after menstruation, but closer to ovulation becomes stretchy in its consistency and increases in volume to aid in fertilisation.
“The cervical mucus during a female’s fertile period acts as a biological reservoir which is receptive to sperm. It provides the sperm nourishment, protection and energy as it traverses the female genital tract to potentially fertilise an egg. Sperm filtration and capacitation are also facilitated by this cervical mucus, but after ovulation the cervical mucus becomes thickened and prevents sperm from entering the cervix,” Dr Neely-James underscored.
She explained that in the case of hostile cervical mucus, the mucus is thick, dry or cloudy brown and obstructs the passage of sperm through the cervix into the uterus at the time of ovulation. The ob-gyn said that it may also result in sperm destruction since it contains antibodies which can destroy sperm, as well as allowing the vaginal bacteria to attack sperm.
She further established that cervical mucus, which is generally a sperm aid, may become hostile for a number of reasons:
•Vaginal dryness which can decrease cervical mucus can be deemed hostile because it restricts sperm motility.
•An increase in the vaginal pH
•Medications such as the fertility drug clomiphene citrate at high doses. Common medications such as antihistamines have also been associated with this change in the body
•Cervical infection is also a significant contributor to hostile cervical mucus. For women who may have had cervical procedures, these could damage the cervical glands and thus alter the functions of cervical mucus, making it hostile to sperm transport.
“Correcting hostile mucus hinges on the treatment of the underlying cause. For women with vaginal dryness, the use of vaginal lubricants has been beneficial because it aids in sperm motility. If the hostile mucus is due to cervical infection, once the infection is treated in most cases hostile mucus is resolved. For women on fertility drugs such as clomiphene citrate, decreasing the dose has been shown to improve the consistency of the mucus and improve fertility, and decreasing antihistamines has also shown improvement,” Dr Neely-James advised.
She notes that other treatment methods such as hormonal therapy have been shown to be of benefit and improve fertility. Guaifenesin, which is a common ingredient in cough medication, can thin the cervical mucus to make it more functional. Fertility-friendly lubricants are also an option. Evening primrose is another great natural option usually used in post-menopausal women, but a lot of young menstruating women have been known to benefit from its use in improving cervical mucus.
Dr Neely-James said that it is crucial to identify hostile cervical mucus. Couples who are trying to conceive should always check for this and ensure that the culprit at the centre of their fertility woes isn’t just mucus.
