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How Can My Cervical Factor Be Assessed?

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A woman’s cervical mucus needs to be hospitable to sperm for conception to occur. When her mucus is too thick for sperm to swim through, doesn’t contain the right nutrients, or holds antisperm antibodies, sperm can’t reach the egg for fertilization to occur.

Here at the California Center for Reproductive Health, our team considers cervical factor when assessing fertility. Here’s how we evaluate cervical mucus and overcome cervical factor infertility.

About cervical mucus

The cervix is the opening to the uterus. The cervix produces a fluid, called mucus, that is important to conception. You might notice your mucus changes throughout the month due to hormones. Before ovulation, your cervical mucus tends to be thick, white, and dry.

Just before ovulation, the time when an egg is released, your mucus turns clear and slippery. This consistency indicates it’s a great time to try to conceive, as the mucus is ideal for sperm to swim through.

What can go wrong with cervical mucus

In women who have cervical factor infertility, the mucus may contain antisperm antibodies that attack the sperm. The antibodies perceive sperm as a foreign invader, much like bacteria or viruses. The antibodies are produced by a skewed immune system.

Cervical mucus can also be too thick or not have the nutrients to support sperm. Cervical factor infertility may also be caused by certain medications, cervical or uterine surgery, congenital anomalies, and unexplained factors.

Diagnosis of cervical factor infertility

We start your infertility workup with a comprehensive review of your medical history. This can help us determine if you have risk factors that make cervical factor a possible contributor to infertility.

The old way to diagnose cervical factor was a postcoital test. This test searched for sperm in the cervical mucus after intercourse at the time of ovulation. But the postcoital test gave inaccurate and inconsistent information and isn’t the best way to assess cervical factor.

At California Center for Reproductive Health, we use transvaginal ultrasonography and mock embryo transfers. This method is much more reliable in determining whether abnormalities exist within your cervical mucus.

Think of the mock embryo transfer as a trial run of an actual embryo transfer. It allows us to determine the best way for the embryo to enter your uterus and check for problems like scar tissue or poor quality cervical mucus that might deter your ability to successfully conceive with IVF (in vitro fertilization.)

Treatment for cervical factor infertility

For women with mild cervical factor infertility, intrauterine insemination is a valid treatment option. We pass sperm directly into the uterine cavity, bypassing the cervix. This allows the sperm to meet the egg with no swimming required.

IVF is also a an option as is GIFT or ZIFT (gamete or zygote intrafallopian transfer). This procedure takes eggs from your ovaries and puts them in a catheter along with sperm. The gametes (eggs and sperm) or zygote (fertilized egg) are place in the fallopian tubes via a minimally invasive surgical procedure that uses tiny instruments and a micro camera.

If you’re struggling with infertility, reach out to California Center for Reproductive Health. We’ll assess your cervical mucus and other aspects of your reproductive health (and your partner’s) to create a customized plan to help you achieve pregnancy. Call one of our offices in Encino, Alhambra, Valencia, or West Hollywood if you’re ready to explore your fertility options.

See Dr. Mor’s Publications

Eliran Mor, MD

Reproductive Endocrinologist located in Encino, Santa Monica, Valencia & West Hollywood, CA
Reproductive Endocrinologist located in Encino, Valencia & West Hollywood, CA Doctor Mor received his medical degree from Tel Aviv University-Sackler School of Medicine in Israel. He completed a four-year residency in Obstetrics and Gynecology at New York Methodist Hospital in Brooklyn, New York. Subsequently, Dr. Mor completed a three-year fellowship in Reproductive Endocrinology and Infertility […]
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FAQ

What does a reproductive endocrinologist and infertility specialist do?

Reproductive endocrinology and Infertility is a sub-specialty of Obstetrics and Gynecology. In addition to managing medical and surgical treatment of disorders of the female reproductive tract, reproductive endocrinologist and infertility (REI) specialists undergo additional years of training to provide fertility treatments using assisted reproductive technology (ART) such as in vitro fertilization.

Reproductive endocrinologists receive board certification by the American Board of Obstetrics and Gynecology in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility.

When should I see an REI specialist?

In general, patients should consider consulting with an REI specialist after one year of trying unsuccessfully to achieve pregnancy. The chance of conceiving every month is around 20%, therefore after a full year of trying approximately 15% of couples will still not have achieved a pregnancy.

However, if a woman is over the age of 35 it would be reasonable to see a fertility specialist earlier, typically after 6 months of trying.

Other candidates to seek earlier treatment are women who have irregular menses, endometriosis, fibroids, polycystic ovary syndrome (PCOS), women who have had 2 or more miscarriages, or problems with the fallopian tubes (prior ectopic pregnancy).

What are the reasons we are having trouble conceiving?

Approximately 1/3 of the time cause for infertility is a female factor, 1/3 of the time a male factor, and the remaining 1/3 a couples’ factor.

At CCRH, we emphasize the importance of establishing a correct diagnosis. Both partners undergo a comprehensive evaluation including a medical history and physical exam.

Furthremore, the woman’s ovarian reserve is assessed with a pelvic ultrasound and a hormonal profile. A hysterosalpingogram (HSG) will confirm fallopian tube patency and the uterine cavity is free of intracavitary lesions. A semen analysis is also obtained to evaluate for concentration, motility, and morphology of the sperm.

Additional work up is then individualized to direct the best possible treatment option for each couple.

What is IVF? What is the process like?

In vitro fertilization (IVF) is the process that involves fertilization of an egg outside of a woman’s body.

The process starts with fertility drugs prescribed to help stimulate egg development. In your natural cycle, your body is only able to grow one dominant egg, but with stimulation medication we can recruit multiple eggs to continue to grow. After about 8-10 days of stimulation, the eggs are surgically retrieved and then fertilized with sperm in a specialized laboratory. Fertilized eggs are then cultured under a strictly controlled environment within specialized incubators in the IVF laboratory for 3-5 days while they develop as embryos. Finally, embryos (or an embryo) are transferred into the uterine cavity for implantation.

Should I have IVF?

Before deciding if IVF is the right choice, it’s important to sit down with an REI specialist to discuss available treatment options. For some people, other methods such as fertility drugs, intrauterine insemination (IUI) may be the best first choice treatment. At CCRH, we believe each individual couple is unique and not everyone needs IVF.

Is the IVF procedure painful?

While not painful, the fertility medications may some side effects including headaches, hot flashes, mood swings, and bloating. The injection sites may also bruise.

Will IVF guarantee a baby?

Unfortunately, no. Many people think once they start IVF it’s a matter of time that they will be pregnant and have a baby. But according to national statistics per the Society of Assisted Reproduction (SART), on average 40% of assisted reproduction cycles achieve live births in women under age 35. The chances of success then continue to decrease with advancing age.

At CCRH, we employ only evidence-based interventions to ensure patient safety and optimal outcome. While we cannot guarantee a baby, we guarantee that you will receive the best, most advanced, personalized care to help you maximize your chance of a baby.

What is the success rate for IVF?

The average IVF success rate (success measured in live birth rate) using one’s own eggs begins to drop around age 35 and then rapidly after age 40. This is due to the decline in egg quantity and egg quality as a woman ages.

Our clinic’s success rate consistently beats the national average year after year.

Do insurance plans cover infertility treatment? How much does IVF cost?

Individual insurance plans often do not have any coverage for infertility treatments. If you have a group plan, you can call members services to see if they have coverage for infertility (including consultation/workup and IVF).

After your consultation with our REI specialist, one of our dedicated account managers with sit with you to go over the cost of treatment.

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