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Contraception. 2010 Dec;82(6):491-6. doi: 10.1016/j.contraception.2010.06.006. Epub 2010 Jul 22.

Effects of the levonorgestrel-releasing intrauterine system on cervical mucus quality and sperm penetrability.

Author information

1
LAC+USC Medical Center, Los Angeles, CA 90033, USA. radhalewis@yahoo.com

Abstract

BACKGROUND:

In levonorgestrel intrauterine system (LNG-IUS) users, the prevention of sperm penetration through cervical mucus has not been demonstrated.

STUDY DESIGN:

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.

[Indexed for MEDLINE]

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