title: Effects of the levonorgestrel-releasing intrauterine system on cervical mucus quality and sperm penetrability.
abstract: BACKGROUND
  In levonorgestrel intrauterine system (LNG-IUS) users, the prevention of sperm penetration through cervical mucus has not been demonstrated.
  
  
  METHODS
  Subjects were enrolled in an investigator-blinded study to compare quality and sperm penetrability of mid-cycle cervical mucus between LNG-IUS users and hormone-free controls. Cervical mucus was microscopically examined using World Health Organization (WHO) cervical mucus analysis (CMA). CMA score ≥10 of 15 points indicated cervical mucus favoring sperm penetration. Mucus was incubated with sperm using the WHO simplified slide test (SST) and Kremer sperm cervical mucus penetration test (SCMPT).
  
  
  RESULTS
  Data from 14 LNG-IUS users and 16 controls showed 14% of LNG-IUS users had CMA score ≥10% vs. 69% of controls (p=.004). SST showed no sperm penetration for LNG-IUS users, significantly less than controls (0% vs. 64.3%, p<.001). SCMPT demonstrated no sperm mucus penetration for LNG-IUS users at 2 and 6 h (0% vs. 85% in controls with 2-h score ≥6, p<.001; 6 h 0% vs. 79% in controls, p<.001).
  
  
  CONCLUSIONS
  Mid-cycle cervical mucus of LNG-IUS users is poor quality and prevents endocervical sperm transport in vitro.
authors.affiliation: LAC+USC Medical Center, Los Angeles, CA 90033, USA. radhalewis@yahoo.com
authors.forename: Radha A
authors.initials: RA
authors.lastname: Lewis
authors.forename: Deshawn
authors.initials: D
authors.lastname: Taylor
authors.forename: Melissa F
authors.initials: MF
authors.lastname: Natavio
authors.forename: Alexander
authors.initials: A
authors.lastname: Melamed
authors.forename: Juan
authors.initials: J
authors.lastname: Felix
authors.forename: Daniel
authors.initials: D
authors.lastname: Mishell
mesh_terms: D000293:Adolescent; D000328:Adult; D002582:Cervix Mucus / Q000187:drug effects*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D008297:Male; D013083:Sperm Transport / Q000187:drug effects; D013084:Sperm-Ovum Interactions / Q000187:drug effects*; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel