左炔诺孕酮宫内节育系统对宫颈黏液质量和精子穿透性的影响。
Effects of the levonorgestrel-releasing intrauterine system on cervical mucus quality and sperm penetrability.
机构信息
LAC+USC Medical Center, Los Angeles, CA 90033, USA.
出版信息
Contraception. 2010 Dec;82(6):491-6. doi: 10.1016/j.contraception.2010.06.006. Epub 2010 Jul 22.
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.
背景
在左炔诺孕酮宫内节育系统（LNG-IUS）使用者中，并未证明其能够阻止精子穿透宫颈黏液。
研究设计
本研究将受试者纳入研究者设盲试验，以比较 LNG-IUS 使用者与无激素对照组在月经中期宫颈黏液的质量和精子穿透性。使用世界卫生组织（WHO）宫颈黏液分析（CMA）对宫颈黏液进行显微镜检查。CMA 评分为 15 分中的≥10 分表示宫颈黏液有利于精子穿透。使用 WHO 简化玻片试验（SST）和 Kremer 精子宫颈黏液穿透试验（SCMPT）孵育黏液和精子。
结果
来自 14 名 LNG-IUS 使用者和 16 名对照组的数据显示，14%的 LNG-IUS 使用者的 CMA 评分为≥10%，而对照组为 69%（p=.004）。SST 显示 LNG-IUS 使用者没有精子穿透，明显低于对照组（0% vs. 64.3%，p<.001）。SCMPT 显示 LNG-IUS 使用者在 2 小时和 6 小时时没有精子穿透黏液（0% vs. 对照组 2 小时评分≥6 时为 85%，p<.001；6 小时时为 0% vs. 对照组为 79%，p<.001）。
结论
LNG-IUS 使用者的月经中期宫颈黏液质量差，并阻止了宫颈内的精子运输。
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