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The pH as an important determinant of sperm-mucus interaction
W Eggert-Kruse1, A Köhler, G Rohr
1Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Germany.
Fertility and Sterility
|March 1, 1993
Summary
Endocervical mucus pH significantly impacts sperm-mucus interaction and fertility outcomes. Routine pH testing during infertility investigation is recommended for better assessment of spermatozoal viability.
Area of Science:
- Reproductive endocrinology
- Infertility diagnostics
- Sperm-cervical mucus interaction
Background:
- Infertility affects numerous couples worldwide, necessitating improved diagnostic tools.
- Sperm-mucus interaction is a critical factor in natural conception and assisted reproductive technologies.
- Endocervical mucus quality, including its pH, plays a pivotal role in sperm transport and viability.
Purpose of the Study:
- To evaluate the clinical significance of endocervical mucus pH in sperm-mucus interaction.
- To correlate endocervical pH with postcoital testing (PCT) results and other infertility parameters.
- To assess the impact of endocervical pH on subsequent fertility outcomes.
Main Methods:
- Prospective study involving 216 infertile couples.
- Determination of endocervical pH using colorimetric and electrometric methods.
- Correlation of pH with PCT, cervical mucus (CM) quality, hormonal status, and fertility outcomes; in vitro sperm-cervical mucus penetration test (SCMPT) utilized.
Main Results:
- Colorimetric pH determination is a reliable and clinically applicable method, correlating well with electrometric measurements.
- Endocervical mucus pH significantly correlates with PCT results, even after accounting for mucus and semen variables.
- Lower mucus pH was associated with hyperandrogenemia and negatively impacted pregnancy rates in primary infertility and oligozoospermia cases; in vitro tests confirmed pH influence on sperm-mucus interaction.
Conclusions:
- Endocervical mucus pH is a crucial indicator of mucus quality, significantly influencing sperm viability within the mucus.
- Mucus pH correlates with peripheral hormonal status and can be modulated by estrogen therapy.
- Routine determination of endocervical mucus pH during infertility investigations, particularly with PCT, is recommended.