Temporal relationship and reliability of the clinical, hormonal, and ultrasonographic indices of ovulation in infertile women

Article Abstract:

Knowing the exact time of ovulation is useful both for planning and preventing pregnancy. Symptoms signaling ovulation include changes in basal body temperature (BBT), changes in the character of the cervical mucus, enlargement of egg follicles in the ovaries, and a surge of luteinizing hormone (LH) in the blood. Although BBT patterns are the most widely used, they are not reliable. The LH surge is the only reliable predictor of ovulation, but the inconvenience of frequent laboratory visits and high cost make it impractical for routine use. Test kits are currently being developed for home use. The relationship between hormones, symptoms and ultrasonographic findings during ovulation was studied among 50 ovulating infertile women. Daily measurements of estrogen, progesterone, and LH, along with ultrasonographic images of the ovaries and BBT determinants, were made for one complete menstrual cycle. There were a total of 50 ovulatory cycles; 40 were spontaneous and 10 were stimulated by clomiphene citrate, an ovulation-inducing agent. Ovarian egg follicle rupture was confirmed by ultrasonographic imaging in 47 cycles (94 percent). All 50 cycles had a mid-cycle LH surge, a rise in progesterone (greater than 10 nanograms per milliliter) and BBT rise. In three patients, the follicle continued to grow without evidence of rupture, even with a mid-cycle surge, which was subsequently diagnosed with luteinizing unruptured follicle syndrome. In three patients the LH increased at the same time ultrasound confirmed follicle rupture. Follicle rupture occurred on day one in three women, on day two in 34 women on day three in 10 cycles. Progesterone increased on the same day as LH surge in 30 percent of the women, one day later in 40 percent, two days later in 22 percent and three days later in 8 percent. Although the rise in progesterone, follicle rupture and rise in BBT followed in sequence, the time between these events varied. Ultrasonographic imaging was useful in confirming ovulation and diagnosing unruptured follicle syndrome, but was not a reliable predictor of ovulation on its own since the size of the follicles varies. BBT and cervical mucus were not valuable predictors of ovulation. The LH surge detected in the urine or blood predicted ovulation reliably. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Ovaries

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Fimbrioscopy and salpingoscopy in patients with minimal to moderate pelvic endometriosis

Article Abstract:

Endometriosis is a condition in which uterine tissue is present in abnormal locations in the pelvic and/or abdominal cavity. To learn more about the health of the fallopian tubes in women with endometriosis, 100 patients were examined by salpingoscopy and fimbrioscopy (techniques of visualizing the length of the fallopian tube and its end, respectively) during laparoscopy (introduction of a tube and optical system into the abdominal cavity). The patients had minimal or moderate endometriosis; sixty-one were infertile and the rest were examined because of pelvic pain. Twenty women without endometriosis who underwent laparoscopy for other reasons served as controls. Results showed that five endometriosis patients had adhesions (fibrous tissue) near the fimbria (the end of the tube farthest from the uterus). No control patient had such adhesions; however, this was not a statistically significant difference. Although more patients than controls had cysts around the fallopian tubes, there was no difference in this variable between the groups. Other aspects of tubal morphology were similar for patients and controls; on the whole, the tubes of women with endometriosis showed normal patterns of folds and flattening. Salpingoscopy is more useful for examining the fallopian tubes of patients with conditions other than endometriosis. The results indicate that endometriosis is not associated with disease within the fallopian tubes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Endometriosis, Fallopian tubes

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Ovulation prediction by monitoring salivary and vaginal electrical resistance with the PEAK Ovulation Predictor

Article Abstract:

The ovulation cycle of 21 infertile, spontaneously ovulating women was monitored using Micron Medical Inc's PEAK Ovulation Predictor, a machine which measures vaginal and salivary electrical resistance. The PEAK Ovulation Predictor was evaluated along with several other methods of determining ovulation. Ovulation is the development and release of an egg (ovum) from a follicle within the ovary. At mid-cycle, the luteinizing hormone (LH) causes one ripe egg to be released. LH levels in the blood and urine were measured and compared to results from the PEAK Ovulation Predictor method. The PEAK Ovulation Predictor did not reliably predict ovulation. While measurements of electrical resistance did not accurately determine LH levels in the blood, salivary and vaginal electrical resistance measurements may be helpful in timing inseminations. Twice-daily urine LH testing accurately detected the surge in LH levels in the blood.

Saliva, Menstrual cycle, Vagina

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