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Rapid immunochemical assay of pregnanediol-3-glucuronide in urine and its clinical application.

A rapid and simple technique for assessing ovulation and luteal function is needed in clinical practice. A sensitive immunoassay kit is presented here for clinical use. An immunoassay of pregnanediol-3-glucuronide (Pd-3G) in urine was established. The sensitivity of this assay was 0.4 mg/l of Pd-3G. The standard error range of the recovery test was within 0.8 mg/l, and the coefficients of variation of within-run and day-to-day precision test were within 4%. Cross reactions of various steroids were observed in free pregnanediol, pregnanetriol and progesterone, but their reactivity exhibited less than 4%. The Pd-3G/creatinine (mg/g) ratio was demonstrated as nearly constant over a 24-hour period. A significant rise of Pd-3G coincided with a luteinizing hormone surge and continued during the luteal phase in the ovulatory menstrual cycle. In an anovulatory cycle, Pd-3G was found to be under 4 mg/g creatinine. This Pd-3G direct-assay method could be widely used in infertility clinics.

Adult↗

Ultrasound increases the prognostic value of the postcoital test.

The prognostic value of the postcoital (PC) test was studied in two groups of women in whom the infertility workup differed only in the way the PC test was timed. Fifty patients were investigated in a traditional way. In this group the PC test failed to have any substantial prognostic value. In a second group consisting of 54 patients, the PC test was timed applying ultrasonographic criteria for ovarian follicular development. This resulted in a highly significant prognostic test. Timing of the PC test by ultrasound enhanced both the reliability and the efficacy of the standard fertility investigation.

Cervix Mucus↗

The clinical significance of rheometric measurement of cervical mucus properties.

Rheometric properties of cervical mucus were studied with the Ovutimer in 26 women. 14 women had regular menstrual cycles, 12 had menstrual irregularities and received treatment to induce ovulation. In 21 women (80.7%) a significant correlation was found between the ovulation time as established by the luteinizing hormone surge, and ovulation time as established by the Ovutimer test. The instrument was found satisfactorily accurate in establishing the day of ovulation in almost all cases.

Anovulation↗

Cervical mucus and prediction of the time of ovulation.

12 normal ovulatory women were studied during 17 menstrual cycles. The first day on which the women had increasing quantities of 0.1 ml or more clear cervical mucus (IQCCM) was closely related to the time of ovulation as monitored by basal body temperature and radioimmunoassay of serum-luteinizing hormone, follicle-stimulating hormone, estradiol, and progesterone. The results show that the time of ovulation can be predicted clinically without specialized tests by observing the day of onset of IQCCM.

Adult↗

Ovulatory cycle characteristics in Macaca fascicularis.

A total of 595 menstrual cycles were studied in 28 adult M. fasicularis over a period of five years. Ovulations, observed laparoscopically in 138 cycles, occurred on the left ovary 62.6% of the time. No significant effect was noted on cycle length relative to the ovulatory status of the previous cycle or the occurrence of ovulation on the same ovary in consecutive cycles. Laparoscopy had no effect on the parameters studied.

Animals↗

Potential fertility--defining the window of opportunity.

The ClearPlan Easy Fertility Monitor predicts the times of high potential fertility, i.e. the times when sexual intercourse is most likely to result in conception. The test procedure identifies the times of specified changes in the concentration of urinary hormone metabolites during each ovarian cycle. The results are displayed in terms of prior knowledge about the time-specific probabilities of conception. This paper contains a summary of the scientific background that led to the development of the ClearPlan Easy Fertility Monitor.

Cervix Mucus↗

Home monitoring with the ClearPlan Easy Fertility Monitor for fertility awareness.

Many couples planning a pregnancy have had to gauge the best time for sexual intercourse from subjective indications, e.g. cervical mucus changes, or retrospective information, e.g. temperature and calendar methods. Between women, and within a woman, there are considerable variations in menstrual cycle length and underlying hormonal patterns. Although fertility test kits are available, most still rely on visual interpretation by the user. A new combination of immunochemical testing and computing technology is now available in the ClearPlan Easy Fertility Monitor. This paper describes the features of this accurate, simple-to-use, home-based fertility monitor, which gathers data on hormonal patterns and takes account of the individuality of menstrual cycles in women. These data and information about other events, such as sexual intercourse, can be stored in the monitor and accessed by the couple and their medical professional for retrospective review. The monitor is useful for couples who have just started trying to conceive, or those who have been planning a pregnancy for some time.

Estrone↗

Trial protocol and sample result of a study comparing the Clearplan Easy Fertility Monitor with serum hormone and vaginal ultrasound measurements in the determination of ovulation.

This paper presents a preliminary result from a study designed to evaluate the ability of the ClearPlan Easy Fertility Monitor to predict ovulation, compared with conventional methods of ovulation determination, i.e. serum hormone measurements (estradiol and luteinizing hormone) and vaginal ultrasound scans (follicle size and endometrium thickness). Fifty-five female volunteers will be monitored over 3 consecutive monthly cycles. Preliminary data gathered from one volunteer are included in this presentation. These data indicate that the ClearPlan Easy Fertility Monitor predicted ovulation as accurately as serum hormone measurements and vaginal ultrasound scans. The results show that this monitor has potential as a home-based ovulation predictor for couples attempting to conceive.

Adolescent↗

Acceptability of home monitoring as an aid to conception.

This paper considers the concept of consumer acceptance of medical products and its importance to successful healthcare provision. The critical dimensions ('domains') of acceptance for a product designed to assist family planning, and the importance of using high-quality psychometric scales to assess these domains, are discussed. Qualitative and quantitative data from acceptance studies with a personal contraceptive monitor, PERSONA, are presented. These data indicate that the monitor is user-friendly and acceptable to couples, and underline the importance of user acceptability for home monitors designed to assist family planning--including those used for conception purposes.

Consumer Behavior↗

'Patient failure' as a reliability model for the 'minipill': a clinical study.

A trial was carried out in 10 healthy women to study the effects of withdrawal of treatment with 0.5 mg lynestrenol per day, for 3 successive days during the pre-ovulatory phase, on the physiological properties of the cervical mucus, vaginal cytology and pituitary and ovarian functions. In most cases, the amount, Spinnbarkeit and ferning of the cervical mucus and sperm penetration remained the same as that before interruption of treatment. In 2 women, the ferning altered to 'good' for 2 to 3 days as the amount of mucus increased slightly. Spinnbarkeit increased at the same time and sperm penetration was good. The changes in LH and FSH excretion suggested that ovulation possibly took place in 1 of the women studied. A mid-cycle oestrogen peak was seen in 2 women. No side-effects were reported during the study apart from irregular intermenstrual bleeding in 1 woman.

Adult↗

Cervical mucus symptom and daily fecundability: first results from a new database.

With the collaboration of Italian centres providing services on natural family planning, a prospective study collected data on 2755 menstrual cycles of 193 women. A database was constructed using information on the daily characteristics of cervical mucus and episodes of intercourse. Taking the day of peak mucus as a conventional marker of ovulation, the database identified the length (12 days) and location of a 'window' of potential fertility, the highest level of conception probability being confined to the central five to six days. Univariate analysis provided evidence of the impact on fecundability of the woman's age and the basic infertile pattern of a cycle. Several analytical approaches highlighted the relationship between daily mucus characteristics and levels of fecundability

Adolescent↗

Epidermal growth factor activates reproductive behavior independent of ovarian steroids in female rodents.

Sex steroids exert profound influence on neural development and function through activation of intranuclear receptors. However, during sexual differentiation and at onset of puberty, intracerebral estrogen (E) availability is subsequent to these effects. The potent mitogen epidermal growth factor (EGF) activates estrogen receptor (ER)-dependent transcription in cultured cells in the absence of exogenous E. Since reproductive behavior in female rodents is the result of E-dependent transcriptional activity and protein synthesis, lordosis serves as a well established in vivo model for probing cellular and molecular mechanisms of steroid receptor-dependent behavior. Here we demonstrate that EGF can signal through the classical E receptor (ERalpha) to alter in vivo function in rodent central nervous system. EGF and EGF receptor ligands induced lordosis in a dose- and time-dependent manner in the absence of steroid treatment in ovariectomized rats and mice. Using antisense oligonucleotides, pharmacological and antibody blockade, and mutant mice, we also report that this behavioral responsiveness is mediated through ERalpha by specific stimulation of membrane-bound EGF receptors and EGF receptor-specific tyrosine kinase rather than by direct ligand activation of the ERalpha. Of biological significance, delayed onset of puberty and the absence of synchronization between reproductive behavior and ovulation was detected in intact mutant Wa-2 mice that express a naturally occurring point mutation in the EGF receptor. To our surprise, EGF-mediated behavior was independent of progesterone (P) and progesterone receptor (PR) since antiprogestins, PR antisense oligonucleotides, and targeted disruption of PR in ovariectomized transgenic mice failed to impede the display of lordosis after EGF. Finally, we also found that another growth factor, insulin-like growth factor-1, which provokes ER-dependent transcription in vitro, activates mating behavior in a similar E-independent manner. Thus, growth factor mediation of ER-targeted function may be a universal feature in the rodent central nervous system, raising critical questions about the role of growth factors in mediating ER-dependent processes in development and reproduction.

Aging↗

Predicting menstrual migraine with a home-use fertility monitor.

A home-use fertility monitor was used to time perimenstrual prophylaxis in 27 women with menstrual or menstrually related migraine. Cycle length variability was mostly caused by follicular phase variability; the postovulatory luteal phase was relatively constant. The monitor accurately identified ovulation in >90% of cycles, enabling prediction of menstruation and precise timing of perimenstrual prophylaxis. Ninety-seven percent of women found the monitor useful in predicting menstrual migraine attacks.

Adult↗