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Ovulation as determined by transrectal ultrasonography in multiparous sows: relationships with oestrous symptoms and hormonal profiles.

Twenty-four cross-bred multiparous sows in their second and fourth parities were studied during two consecutive oestruses after weaning. Careful oestrous control was done on the animals and ovulation was monitored by transrectal ultrasonography. Blood for analysis of LH and E2 contents was collected through an indwelling catheter. The sows were mated/inseminated once approximately 18 h before expected ovulation in their second oestrus. The interval between weaning and ovulation varied from 86 h-204 h (153 +/- 26). Onset of standing oestrus to ovulation was found to be longer in sows with long oestruses and ovulation occurred within a mean of 68% of the oestrous period. Duration of the first pro-oestrus was significantly shorter than the second pro-oestrus (40 h and 71 h, respectively). There was no significant difference within sows for the intervals from onset of oestrus to ovulation during the first and second oestrus after weaning (37 h and 39 h, respectively). The diameter of the largest follicles at onset of oestrus and at ovulation had very small variation between animals. The mean intervals from E2 peak to onset of oestrus and to ovulation were 1 h (range -10-(+)22 h) and 44 h (range 34-54 h) respectively, and from LH peak to onset of oestrus and to ovulation 12 h range -10-(+)32 h) and 35 h (range 27-48 h), respectively. The present study indicates that repeated ultrasonographic examination of ovaries during one oestrus can be used to predict the time of ovulation during the subsequent oestrus.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Assessment of ovarian function in perimenopausal women after stopping oral contraceptives.

Ovarian function was assessed by measuring plasma gonadotrophins, urinary oestrogen and urinary pregnanediol levels, every week for four weeks, in 34 women, aged 45 to 57 years, after withdrawal of oral contraceptive therapy. A rise in urinary pregnanediol excretion occurred in 14 patients suggesting that ovulation had occurred and that these patients were "premenopausal". Elevated serum gonadotrophin values and persistently low urinary oestrogen and pregnanediol excretion occurred in 13 patients suggesting ovarian failure or a "postmenopausal" state. However, one apparently "postmenopausal" patient later showed hormonal evidence of ovulation, indicating fluctuation in ovarian function. There were 7 patients with "indeterminate" hormone profiles whose ovarian function was difficult to assess. All patients excreting more than 45 nmol of oestrogen a day had a spontaneous period within 45 days of stopping hormone therapy.

Adult↗

Relation between the luteinizing hormone peak, the nadir of the basal body temperature and the cervical mucus score.

The results of a cervical mucus scoring system and of basal body temperature (BBT) chart interpretation were compared with those of a short-incubation radioimmunoassay for luteinizing hormone (LH) in 198 ovulatory menstrual cycles. The timing of the maximal cervical mucus score was similar to that of the LH peak in all but 7% of assessable cycles. In contrast, the timing of the nadir of the BBT differed widely from that of the LH peak in 45% of cycles with interpretable charts. These findings suggest that cervical mucus scoring might be useful for identifying the time of ovulation where LH assays are unavailable or where speed and economy are at a premium.

Body Temperature↗

Does early growth delay occur in diabetic pregnancy?

OBJECTIVE: To identify the date of ovulation in pregnant women with Type 1 diabetes in order to assess the validity of the concept of early growth delay. DESIGN: Identification of ovulation by measurement of urinary luteinising hormone and assessment of fetal growth using ultrasound scan. SETTING: Diabetic pre-pregnancy and antenatal clinic in a teaching hospital. SUBJECTS: Twenty women with Type 1 diabetes who had attended a pre-pregnancy clinic. MEASURES: Urinary LH, by laboratory and kit methods, during conception cycles. Human chorionic gonadotrophin measured in early pregnancy. Early ultrasound scans by a single observer blind to menstrual and ovulation dates. OUTCOME: Gestation calculated from ovulation date and gestation estimated from menstrual dates, compared with gestation at age indicated by early ultrasound scan. RESULTS: When the date of ovulation was identified in 20 women with Type 1 diabetes there was no evidence of growth delay in any pregnancy. When gestation was estimated from menstrual dates there was apparent early growth delay in six pregnancies. CONCLUSION: This study, together with others discussed, indicates that early growth delay is probably an artefact of incorrectly estimated ovulation date.

Diabetes Mellitus, Type 1↗

An evaluation of teaching cervical mucus symptoms to ovulating infertile women.

Women (n = 113) with ovulatory menstrual cycles but complaining of infertility were instructed in the observation and charting of cervical mucus symptoms. At the completion of 3 teaching cycles, 80 subjects (70.8%) had successfully charted at least one cycle with an ovulatory mucus pattern (10 subjects became pregnant). Sixty-two (54.9%) of the women continued for a further 3 cycles of investigation during which, around the time of ovulation, an assessment was made of the mucus at the cervix. On the basis of this assessment subjects were classified as either Group 1: charting ovulatory mucus symptoms with 'fertile type' mucus observed at the cervix - 48 subjects (10 became pregnant); Group 2A: charting uninterpretable mucus symptoms but 'fertile type' mucus observed at the cervix - 8 subjects; or, Group 2B: charting uninterpretable mucus symptoms and mucus of poor quality observed at the cervix - 6 subjects. The study shows that infertile ovulating women can be taught to observe and chart their mucus symptoms. Such charting is useful in identifying the fertile period of the cycle for timing of intercourse and for timing of postcoital tests and cervical assessment. It is also useful in identifying the small number of women (5.3%) with an apparent deficiency in mucus production. Whether the 20 subjects (17.7%) who became pregnant were assisted in this objective by their charting of symptoms is unclear.

Body Temperature↗

What are the ultrasound and biochemical features of impending ovulation?

Thirty-two ovulatory women had serial ultrasound measurements of uterine volume, endometrial thickness and leading follicular diameter compared with serum oestradiol, testosterone and sex-hormone binding globulin. Follicular diameter, endometrial thickness and uterine volume were significantly correlated with serum oestradiol. The day before ovulation was characterized by maximal values for oestradiol, testosterone, luteinizing hormone, endometrial thickness, uterine volume and leading follicular diameter. Leading follicular diameter and endometrial thickness in particular, appear to be useful parameters to indicate impending ovulation.

Endometrium↗

Simple office methods to predict ovulation: the clinical usefulness of a new urine luteinizing hormone kit compared to basal body temperature, cervical mucus and ultrasound.

A new urine luteinizing hormone (LH) kit, First Response (Tambrands Inc., Palmer, MA) was compared with basal body temperature (BBT), cervical mucus scoring and abdominal ultrasound follicular scanning in their ability to predict ovulation to within 2 days of the serum LH peak. BBT was kept daily. From day 10 daily ultrasound scanning and cervical mucus examination were performed and serum oestradiol, luteinizing hormone, follicular stimulating hormone and progesterone were assayed. First Response was significantly more accurate than BBT and cervical mucus when compared in their ability to predict ovulation to within 2 days of the LH peak (p less than 0.05). First Response pinpointed 93% (27/29) of the ovulatory cycles compared to 72% (18/25) and 61% (19/31) for BBT and cervical mucus respectively. It was better but not significantly so against abdominal ultrasound which predicted 77% (24/31). The implications of this finding and the value of the other simple office tests in clinical practice are discussed.

Ambulatory Care↗

Fertility awareness in women attending a fertility clinic.

Eighty women attending for consultation at a tertiary referral fertility unit over a 3-month period were surveyed for their knowledge of fertility awareness and how they used this information to enhance their chances of conception. It was hypothesized that less than 50% of the subjects had an adequate understanding of when the fertile time occurred in their menstrual cycle. A questionnaire was completed anonymously by each subject and these were scored in 3 categories for fertility awareness by 2 independent Natural Family Planning teachers. Scores ranged from 0 for women who had no concept of fertility awareness, to 6 for women who were highly aware. The results showed that 26% (N = 21) of subjects had a score of 4 or greater which was considered as having an adequate understanding. The hypothesis was accepted, giving reason for concern about the effectiveness of consumer education at all levels of fertility investigation.

Adult↗

Artificial insemination: an overview.

This article presents an overview of the indications for and techniques of artificial insemination, including artificial insemination of husband's/partner's sperm and artificial insemination of donor sperm. Important issues related to psychologic, legal, and ethical concerns are addressed, as well as long-term ramifications and implications for nursing.

Anger↗

The use of breastfeeding as a contraceptive.

Breastfeeding generally is considered an ineffective method of birth control. Yet, in non-Western cultures breastfeeding has been shown to be a beneficial method for spacing births. The physiological effect of breastfeeding on ovulation, breastfeeding patterns that delay the return of ovulatory activity, and the practice of fertility awareness during the postpartum period are reviewed. Guidelines are suggested for assessing, teaching, and referring women desiring to use breastfeeding as a contraceptive method.

Breast Feeding↗

Professional and lay interrater reliability of urinary luteinizing hormone surges measured by OvuQuick test.

OBJECTIVE: To determine the reliability of women, unmotivated by fertility problems, to accurately assess and record the urinary luteinizing hormone surge indicated by color changes on OvuQuick test pads. DESIGN: A descriptive, correlational study testing the reliability and validity of an instrument. SETTING: The participants' homes. PARTICIPANTS: 114 college-educated, white women. INTERVENTIONS: An OvuQuick Test Kit and a Menstrual Cycle Diary were mailed to each participant. The monthly diary and test pads of the participants were reassessed by a master's-prepared nurse. MAIN OUTCOME MEASURES: Women without medical or health-care training are reliable in judging the color changes on the OvuQuick test pads and recording these results in a menstrual diary. RESULTS: Investigator and subject assessment and recording of luteinizing hormone surge results agreed 95% (284 of 300 instances) of the time. In addition, the validity of the luteinizing hormone surge for predicting ovulation was accurate in 93% (26 of 28 instances) of the cases. CONCLUSION: OvuQuick is a reliable and valid test for home evaluation of luteinizing hormone surge and prediction of ovulation.

Adult↗

Variability in the phases of the menstrual cycle.

OBJECTIVE: To determine variability in the phases of the menstrual cycle among healthy, regularly cycling women. DESIGN: A prospective descriptive study of a new data set with biological markers to estimate parameters of the menstrual cycles. PARTICIPANTS: One hundred forty one healthy women (mean age 29 years) who monitored 3 to 13 menstrual cycles with an electronic fertility monitor and produced 1,060 usable cycles of data. MEASURES AND OUTCOMES: Variability in the length of the menstrual cycle and of the follicular, fertile, and luteal phases, and menses. The estimated day of ovulation and end of the fertile phase was the peak fertility reading on the monitor (i.e., the urinary luteinizing hormone surge). RESULTS: Mean total length was 28.9 days (SD = 3.4) with 95% of the cycles between 22 and 36 days. Intracycle variability of greater than 7 days was observed in 42.5% of the women. Ninety-five percent of the cycles had all 6 days of fertile phase between days 4 and 23, but only 25% of participants had all days of the fertile phase between days 10 and 17. CONCLUSIONS: Among regularly cycling women, there is considerable normal variability in the phases of the menstrual cycle. The follicular phase contributes most to this variability.

Adult↗

Localization of mast cells in endometrial cysts.

PROBLEM: Although the presence of mast cells in endometriosis lesions has been reported, there have been no reports of their pathological localization in ovarian endometrial cysts. METHODS OF STUDY: The localization of mast cells in ovarian endometrial cysts were investigated using hematoxyline and eosin and toluidine blue staining with light microscopy, immunohistochemical c-kits, and electron microscopy. RESULTS: Mast cells were identified in endometrial cyst tissues. Few mast cells were localized in the endometrial stroma, which is characteristic of endometrial gland-like regions. Many mast cells were noted around blood vessels and the interstitium with fibrosis, that is, the fibrotic interstitium of endometrial cysts. CONCLUSIONS: Mast cells may be involved in the development and progression of endometriosis. Localization of mast cells suggests a particularly close relationship with fibrosis and adhesion.

Adult↗