Nulsen, J., Wheeler, C., Ausmanas, M., & Blasco, L. (1987). Cervical mucus changes in relationship to urinary luteinizing hormone. Fertility and Sterility, 48(5), 783-786. https://doi.org/10.1016/s0015-0282(16)59530-2
Nulsen J, Wheeler C, Ausmanas M, Blasco L. Cervical mucus changes in relationship to urinary luteinizing hormone. Fertil Steril. 1987;48(5):783-786. doi:10.1016/s0015-0282(16)59530-2
Nulsen, John, et al. "Cervical mucus changes in relationship to urinary luteinizing hormone." Fertility and Sterility, vol. 48, no. 5, 1987, pp. 783-786.
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RRM Academy Synopsis
Peak cervical mucus coincided with the urinary LH surge in ten women
Peak mucus scores came on the day of or the day before the urine LH surge. This 1987 hospital study followed ten women who ovulated and were being checked for infertility. The women tested their urine at home twice a day. Mucus scoring and ultrasound were done daily.
Key Findings
Maximal mucus scores fell on the day of the urinary LH surge or the day before it in all ten women. One woman also had maximal scores the day after.
Twice-daily testing found the urinary LH surge in nine of ten ovulatory cycles. Morning-only testing would have found six of ten, afternoon-only testing seven of ten.
Ultrasound evidence of ovulation came 0 to 24 hours after the surge in nine of ten women. In one woman it came in the 24 hours before.
The day after the surge, mucus scores fell by about 50% on average.
Basal body temperature nadir showed no consistent relationship with the surge or with maximal mucus scores.
Interpretation
The study observed ten women at one hospital. Male factor infertility affected most of the couples. One in ten had unexplained infertility. Sperm penetration was measured in the lab with donor sperm. In some cases, penetration scores stayed high for 24 hours after the surge. The authors note that it is not yet known whether this happens inside the body. The authors conclude that mucus is at its best right around the surge. They recommend timing intercourse within 12 hours of it. The findings support larger studies of mucus scoring for timing ovulation.
RRM Context
Fertility awareness-based methods chart cervical mucus as a sign a woman can observe. The authors checked the mucus peak against a urine hormone surge, ultrasound, and blood hormones. Basal body temperature is another common sign. In this study, it gave no steady timing signal for the mucus peak.
Our editorial summary of this paper, not the article's abstract.
Abstract
In order to evaluate the relationship between the urinary luteinizing hormone (LH) surge as detected by the OvuSTICK (Monoclonal Antibodies, Inc., Mountain View, CA) method and daily cervical mucus parameters, ten spontaneously ovulating women undergoing infertility evaluation were followed during their cycles with twice daily urinary LH testing as well as daily ultrasound, mucus evaluation, and hormonal assays of serum LH, progesterone (P), and estradiol (E2). Maximal cervical mucus scores, as determined using a modified Insler score, were noted to coincide consistently with the urinary LH surge as detected by twice daily testing and to precede ultrasound evidence of ovulation by 0 to 24 hours. Mucus scores rapidly declined in the 24-hour period following the urinary LH surge. Detection of the urinary LH surge may therefore help identify that period of time during which cervical mucus parameters are optimal and therefore facilitate the timing of artificial insemination, intercourse, or postcoital testing.
