Mucus Penetration Test is the in-vitro SCM Interactions tests. These are done only if the semen has motile sperms. The timing and method of mucus collection for MPT is same as for PCT.
Fertile type of cervical mucus is collected from within cervix and placed on clean glass slide along with a drop of fresh semen. A cover slip is gently placed on them in such a way that the edges of the two fluids come just in contact with each other and NOT overlap. This edge in contact is then observed under the high power of the microscope at intervals of 10, 20, 30, and 60 minutes. Interpretations are as under.
Sperm invasion of >3 high power fields excludes cervical hostility or inability of the sperms to penetrate. MPT is Positive. No invasion or only minimal invasion may indicate cervical hostility if the semen is good. The result is MPT Negative.
In case of MPT Negative, the test can be repeated with husband’s semen and Donor’s cervical mucus or wife’s cervical mucus & Donor’s semen. The results are interpreted as:
If MPT is positive with Husband’s sperms & Donor’s mucus, there is cervical hostility & NOT sperm’s weakness to penetrate. If MPT is positive with donor sperms & wife’s mucus, the deficiency is in sperm’s power of invasion, NOT cervical hostility.
Sperm Cervical Mucus Interaction Tests have been out of favor recently. That is because they have been converted from a clinical test to a laboratory test. Main objection is from IVF centers. It is true that if ART has been decided such tests are unnecessary, so are many other tests. These are helpful to decide for (IUI)
Hormones are the substances produced by the ductless glands and added to the blood, through which they reach the target organs to produce the desired effect. Therefore they are tested through blood samples. Hormones are also estimated in urine or other body fluids through which they are excreted.
Hormones play an important role in reproduction. The reproductive hormone assays are done by EIA technology. 3-5 mills blood, depending on the number of hormones to be tested is collected. It is centrifuged and serum obtained in which the levels are estimated. Hormones tested as routine are:
- Pituitary Hormones: Follicular Stimulating Hormone (FSH), Luteinizing Hormone (LH), and Prolactin.
- Gonadol Hormones: Estradiol (E 2), Progesterone and Testosterone.
- Placental Hormones: Beta Human Chorionic Gonadotrophins (βhCG).
FSH, LH, Estradiol, Progesterone, Prolactin and in some cases even testosterone levels are estimated in Blood. These are commonly known as female sex hormones. Hormone levels vary at different times of the ovarian cycle. It is important to relate the levels with the time of the cycle. LMP should always be reported at the time of collection of the sample.
Estrogens are important for the development and the maintenance of sexual characteristics. Under FSH stimulation ovaries produce increasing amount of estrogens from the beginning of the ovarian cycle with its peak just before the ovulation. The levels of FSH & estrogen then decrease. Estrogens have the second peak in the late luteal phase. They have Positive and negative feed backs on Hypothalamus and Pituitary.
Physiological Effects of Estrogen is multifocal and self limiting influencing the target tissues, the tissues producing them and the anterior pituitary that ultimately controls the estrogens production. Estrogens are tropic hormones that play paramount role in growth, development & the maintenance of reproductive organs. Estrogen primes up of anterior pituitary for production of gonadotrophins. Estrogen peak precedes LH surge. Fertile type of cervical mucus is produced and uterine Endometrium proliferates. Estrogen also regulates many metabolic processes other than reproduction.
Progesterone is produced by the luteal cells of the ovary after the LH surge. Its limited effects are restricted to the reproductive system. They have role in thermal shift, breast development, and secretory change of endometrium & to maintain a healthy pregnancy.
Androgens are male hormones produced by testes. Small amount are produced by Ovaries. Their excess causes masculinization in female.