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Abnormal cervical mucus may impair fertility by inhibiting penetration or increasing destruction of sperm.

Normally, cervical mucus is stimulated to change from thick and impenetrable to thin and stretchable by an increase in estradiol levels during the follicular phase of the menstrual cycle. Abnormal cervical mucus may

• Remain impenetrable to sperm around the time of ovulation
• Promote sperm destruction by facilitating influx of vaginal bacteria (eg, due to cervicitis)
• Contain antibodies to sperm (occasionally)

Abnormal mucus rarely impairs fertility significantly, except in women with chronic cervicitis or cervical stenosis due to prior treatment for cervical intraepithelial neoplasia.

Diagnosis

Women are examined to check for cervicitis and cervical stenosis. Unless they have one of these disorders, postcoital testing of cervical mucus to determine whether viable sperm are ipresent (which used to be routine during infertility evaluation) is usually unnecessary. Usefulness of postcoital testing has not been documented.

Treatment

Treatment may include intrauterine insemination or drugs to thin the mucus (eg, guaifenesinSome Trade Names
ROBITUSSIN
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). Neither treatment has been proved effective.

Last full review/revision November 2008 by Robert W. Rebar, MD

Content last modified November 2008