“Dr. E” is the creator of a product called PreSeed, something I have mentioned many times on this site. She was nice enough to write this article for us to help educate women about this topic. Nearly everyone I speak to has no idea how hostile cervical mucus can negatively affect their fertility.

Cervical mucus (CM) is a critical part of natural fertility. It is something as women, we are not taught much about, in large part because physicians tend to not be trained in understanding the function and physiology of it.

One of the best books you can read to learn about tracking your own fertile time through CM production is Toni Weschler’s Taking Charge of Your Fertility. This book will help you understand when you are fertile based on CM production.

I was encouraged to see a recent Practice Report for optimizing fertility in a physician’s journal that reviewed studies showing that optimal fertility can be achieved by monitoring CM quality and having intercourse during times of fertile, or egg white CM (they also recommended Pre~Seed in this article for other doctors which made us happy!).

Why is CM so important?
After ejaculation, sperm have to be able to swim through the cervix to reach the Fallopian Tube where fertilization of the egg occurs. The sperm that can fertilize the egg begin leaving the ejaculate within 1 min after deposition, and no sperm that get to the Fallopian Tube have ever been proven to do so after 30 min of ejaculation. You may have heard of the “cervical reservoir” of sperm, but there is no evidence for such storage in the cervix.

Sperm have to get through CM to get to the Fallopian tube where they are then stored for hours to days until the egg comes. However, the interactions of sperm and cervical mucus that allow this migration are often disrupted in fertility patients. It is thought that at least a third (if not more) of sub-fertile couples have some disruption of sperm-cervical mucus interactions that limit sperm transport to the tubes.

The importance of normal CM in natural reproduction is widely recognized. For most of a woman’s cycle the CM is a thick gel and hostile to sperm, with a low pH and a structure that stops sperm transport by the presence of closely spaced microfibers. During ovulation, however, the CM becomes more alkaline (higher pH), and the fibers align in parallel with an expanded distance between them. This allows the sperm to swim through the mucus. Normally, the volume of daily CM also increases 5 fold at ovulation. CM is a hydrogel of 90% water and sugars, and its primary function appears to be bathing sperm in a fluid medium to protect them during transport . The presence of sugar-proteins in the gel that hold the water is controlled by hormone changes at ovulation (especially the presence of estrogen). These sugars increase the mucus gel’s capacity to hold water, expand fiber spacing, & allow sperm migration. Taken together, these changes permit sperm to rapidly swim through the cervix and proceed to the Fallopian tube for fertilization.

In women with poor sperm-CM interaction there is a reduction in CM fiber spacing making sperm migration difficult, a primary cause of which in many women may be inadequate water in the gel. This may be caused by advancing age (with low grade hormonal disruptions); and following the use fertility medication such as clomiphene citrate (CC or clomid). CC is a widely prescribed fertility drug. In fact, it has become increasingly used as a first line therapy for couples with fertility issues. With easy internet access, many women are also taking CC without doctor oversight. Estimates are that 40% of couples with fertility problems utilize CC at some point for the woman. Although it’s wide spread use has helped many couples conceive, it does cause significant problems with vaginal dryness and CM production and function. Specifically, numerous studies have shown that CC causes decreases in: volumes of CM; quality of CM (“egg-white like appearance”); and sperm penetration into CM. In fact, women on CC are seven times more likely to have “hostile” CM that is difficult for sperm to penetrate than are women not on the medication.

Women on CC also have an increased prevalence of vaginal dryness, which can cause pain at intercourse and decrease enjoyment for the man (which can decrease sperm counts). Many women on CC (which is already making them prone to poor sperm-cervical mucus penetration) are therefore also using lubricants that can harm sperm such as KY, Astroglide and Replens. These women may be creating a vaginal environment that limits sperm transport. Pre~Seed “sperm-friendly” Intimate Moisturizer can replenish vaginal moisture without harming sperm. A clinical trial is also planned to evaluate the effect of Pre~Seed on sperm and cervical mucus interactions, especially for women on Clomid.

What can you do to improve CM Quality?
Fertility vitamins (such as FertilAid for Women) may help some women produce better mucus. Decreasing stress and maintaining an optimal body weight it is important too, as being overweight changes your hormone profile. If you are overweight, losing even just 7% of your body weight can help balance hormones. There is a good book on this by Dr. Robert Greene, Perfect Hormone Balance for Fertility. You can learn more about this book at my blog http://www.preseed.com/blog/?m=200806

In addition, my dear friend Dr. Helle has released two new hypnotherapy CDs to help with relaxation and ideal nutrition for TTC. You can learn more about these at http://www.preseed.com/blog

I would also speak to your physician about trying medication other than Clomid – to see if there might be a better option for you with your specific condition. Use Pre-Seed of course for optimal moisture.

Holiday Blessings to Each of You,
Dr. E (inventor of Pre-Seed)