title: Clinical significance of crossed in vitro sperm-cervical mucus penetration test in infertility investigation.
abstract: To evaluate the clinical significance of in vivo and in vitro testing of sperm ability to penetrate cervical mucus (CM), postcoital testing (PCT) and in vitro sperm-cervical mucus penetration testing were compared in a prospective study. Both in vivo and in vitro tests were standardized and performed after an oral course of estrogen therapy. Crossed in vitro sperm-cervical mucus penetration test, evaluated in 277 couples with CM of patients' wives and additionally with CM and semen of fertile donors, revealed that the male factor contributed to a significantly higher extent to deficient sperm-mucus interaction than the cervical factor. The overall pregnancy rate after 6 months was 23% (64/277). Whereas the outcome of PCT did not significantly predict subsequent fertility (PCT good pregnancy rate 24%/PCT poor 20%), significant differences were found for the sperm-cervical mucus penetration test with CM of patients' wives (pregnancy rate, 30.5% versus 8.5%) and for in vitro testing with donors' CM, but not for the mucus penetration test with donors' spermatozoa. Routine sperm analysis did not prove to be of prognostic value for a subsequent pregnancy. The results suggest that the in vitro sperm-cervical mucus penetration test is a good parameter of sperm function and, in particular, when performed as a cross-matching penetrability test, a valuable adjunct to PCT with regard to fertility prognosis.
authors.affiliation: Division of Gynecological Endocrinology, University of Heidelberg, Federal Republic of Germany.
authors.forename: W
authors.initials: W
authors.lastname: Eggert-Kruse
authors.forename: I
authors.initials: I
authors.lastname: Gerhard
authors.forename: W
authors.initials: W
authors.lastname: Tilgen
authors.forename: B
authors.initials: B
authors.lastname: Runnebaum
mesh_terms: D002584:Cervix Uteri / Q000502:physiology*; D003075:Coitus; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D066298:In Vitro Techniques; D007246:Infertility / Q000175:diagnosis*; D008297:Male; D009093:Mucus / Q000502:physiology*; D011379:Prognosis; D011446:Prospective Studies; D013081:Sperm Motility; D013084:Sperm-Ovum Interactions; D013094:Spermatozoa / Q000502:physiology*; D015044:Zona Pellucida / Q000502:physiology