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  • Title: Comparison of the action of nonoxynol-9 and chlorhexidine on sperm.
    Author: Sharman D, Chantler E, Dukes M, Hutchinson FG, Elstein M.
    Journal: Fertil Steril; 1986 Feb; 45(2):259-64. PubMed ID: 3005050.
    Abstract:
    The effect on sperm motility of nonoxynol-9 chlorhexidine diacetate was compared in semen and cervical mucus. Both compounds had similar spermicidal potency in semen, abolishing sperm motility within 3 minutes at 0.5 mg/ml. When these compounds were allowed to diffuse into mucus, the subsequent survival of sperm in the mucus was different. Restricted penetration and loss of motility occurred rapidly after treatment with 0.1 mg/ml chlorhexidine, whereas sperm survived normally in mucus after prolonged contact with 200 mg/ml chlorhexidine. When the compounds were mixed directly with the mucus before sperm penetration was attempted, chlorhexidine still immobilized sperm, but concentrations of nonoxynol-9 that would be spermicidal in semen had no effect in mucus. This study compared the effect of nonoxynol-9 and chlorhexidine in sperm motility in both semen and cervical mucus. Both compounds had similar spermicidal potency in semen, abolishing sperm motility within 3 minutes at 0.5 mg/ml, although the reduction of the proportion of motile sperm at lower concentrations was more marked for chlorhexidine. When these compounds were diffused into mucus, sperm survival showed different patterns. Restricted penetration and loss of motility occurred rapidly after treatment with 0.1 mg/ml of chlorhexidine, whereas sperm survived normally in mucus after prolonged contact with 200 mg/ml of nonoxynol-9. When the compounds were mixed directly with mucus before sperm penetration, chlorhexidine still immobilized sperm, but concentrations of nonoxynol-9 that would be spermicidal in semen had no effect. These findings suggest that nonoxynol-9 does not have access to the domains of the cervical mucus occupied by the swimming sperm; moreover, there is no evidence that this compound is able to diffuse into mucus. The nonoxynol-9 type of spermicide is probably active only in the vagina and sperm that enter the cervical mucus before being immobilized by the spermicide are protected from further action. In contrast, chlorhexidine may structurally alter the cervical mucus, preventing the entry of sperm, or may actively accumulate in mucus to spermicidal levels. The effectiveness of spermicidal vaginal contraception could be improved by extending the area of the female genital tract available to the contraceptive agent. Chlorhexidine provides such an extension.
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