Cyclic changes in the cervical mucus and vaginal epithelium
Cyclic changes in the cervical mucus
♦ Thread test (Spinnbarkeit).
– Technique: put a drop of cervical mucus between 2 slides & then separate (or draw cervical mucus by tip of artery forceps then open).
– Results: if separated, cervical mucus is drawn into threads so, the test is positive.
♦ Fern test:
* Technique:
– Cervical mucus is left to dry on a slide & examined under low power of microscope.
* Results:
– Arborization pattern (palm leaf pattern) is seen because cervical mucus contains Na,
CL & KCL which on drying form fern like crystals.
Cyclic changes in the vaginal epithelium
♦ 1st half of the cycle:
– Main hormone: estrogen effect.
– Criteria:
– Shedding of superficial cells which are characterized by sharp borders, eosinophilic cytoplasm & pyknotic nucleus (deeply stained).
– Maturation index = 0, 30, 70
– 0: parabasal cells.
– 30: intermediate cells.
– 70: superficial cells.
♦ 2nd half of the cycle:
– Main hormone: progesterone.
– Criteria:
– Shedding of intermediate cells which are characterized by folded borders (navicular cells), basophilic cytoplasm & vesicular nucleus.
– Maturation index = 0, 70, 30.
Hormones influences the morphology and staining characters of endometrial, endocervical and vaginal cells. • Non- invasive procedure of epithelium for hormonal status • Vaginal epithelium is very sensitive to estrogen and progesterone. Indication of cytological hormonal evaluation • Assessment of ovarian function • After hysterectomy • During menstrual cycle • In premature menses • Assessment of abnormal hormonal production • Pregnancy , Abortion , Retained placenta • Various endocrine disorders • Existence of hormone producing ovarian tumors • Assessment and guidance of hormonal therapy.