Washington Center for Reproductive Medicine

Cervical Factor Infertility

Cervical disease occurs when the cervical mucus is insufficient, too thick or thin, or hostile to sperm. When antisperm antibodies are present in the cervical mucus, they can incapacitate or destroy sperm. Antisperm antibodies can also be produced by a male to his own sperm. This usually occurs when there has been exposure of semen to blood as in testicular trauma. Some medications, such as Clomid can cause thickening of the cervical mucus.

When antisperm antibodies are present, the immune system "mistakes" sperm for foreign invaders (allergens, virus, bacteria, etc.) and destroys them. Intrauterine insemination (IUI) is often recommended to treat cervical factor infertility. IUI bypasses the cervical mucus by placing specially prepared sperm directly into the uterus using a small catheter. IUI is usually combined with ovulation inducing medications such as follicle stimulating hormone (FSH).

IUI was one of the first infertility treatments and has been successfully used for many years. IUI should only be performed by a physician using sperm that have been specially prepared (concentrated and washed). Use of "unwashed" sperm can lead to very serious allergic reactions.

The post-coital (after intercourse) test is often used to diagnose cervical factor disease. The test is scheduled at specific times during the menstrual cycle. The couple has intercourse and within eight hours, the mucus is collected and examined by Dr. Kustin. The number of sperm present, their shape, ability to swim, the thickness of the mucus, and other factors are assessed.

IUI provides good results when cervical factor disease is the only causative factor. If male factor infertility is present, IVF with ICSI is often recommended as the treatment of first choice dependent upon many patient specific factors.














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