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PubMed1989

Treatments for inducing superovulation and the endocrine aspects of cycle diagnostics in connection with the in vitro fertilization program.

On the basis of literary data and of own experience the author deals with protocols concerning hyperstimulation in the in vitro fertilization and embryonic transfer cases as well as with the endocrine monitoring of superovulatory cycles. The IVF and ET programs widen our knowledge most spectacularly in the fields of follicle maturation, cycle endocrinology, and early processes of reproduction. When discussing the theoretical and practical aspects of various superovulatory treatments, the principal differences between the natural and hyperstimulatory sexual cycles are emphasized. Because of these differences and of the nature of the IVF-ET procedure, the importance of the traditional cycle diagnostics is necessarily limited. More important diagnostic possibilities are the daily quick hormone measurements by RIA methods, the hemagglutination tests, ELISA, and ultrasound examinations.

Corpus Luteum↗
PubMed1985

Serum estradiols versus pelvic sonography in monitoring HMG therapy.

Therapy with human menopausal gonadotropin (HMG) conventionally has been monitored by estrogen measurements. Pelvic sonography may offer a more accurate method of monitoring HMG therapy. In this study 67 anovulatory patients were treated with HMG until at least one follicle had a diameter of 17 mm. The serum estradiol level was noted at the time a mature follicle was achieved. There was a correlation between the ultrasound data and the serum estradiol range in 57% of the cases. However, in 24% it was necessary to push the estradiol level above the allowable maximum of 2000 pg/mL. Twenty percent of the patients attained a 17-mm follicle before reaching the minimum required estradiol level of 500 pg/mL. Sonographic monitoring should improve the efficacy of HMG therapy.

Anovulation↗
PubMed1985

A prospective multicentre study to develop universal immunochemical tests for predicting the fertile period in women. World Health Organisation Task Force on Methods for the Determination of the Fertile Period, Special Programme of Research, Development and Research Training in Human Reproduction.

Two immunochemical tests for predicting the fertile period have been adapted for application throughout the world. The estrone test involves the measurement of estrone-3-glucuronide (E1-3-G) in daily samples of early morning urine. The start of the fertile period is identified by a sustained rise in the concentration of E1-3-G (as determined by cumulative sum analysis); the end of potential fertility occurs 120 hours (5 days) after the peak level. Alternatively, the ratio of E1-3-G to pregnanediol-3 alpha-glucuronide (Pd-3 alpha-G) can be calculated and the fertile period identified between a defined rise in this index and the peak value plus 144 hours (6 days). One hundred thirty-one women from 10 countries provided samples from 557 menstrual cycles, and the results from 455 (82%) were accepted for statistical analysis. There were highly significant differences (P less than 0.0001) in the concentrations of the metabolites between centres, but the time intervals between both the rise and peak days and the day of the luteinizing hormone (LH) peak were less significantly different (P less than 0.05) for the estrone test and not significantly different for the ratio test. The fertile period was defined as the day of the LH peak -3 to the day of the LH peak +2. The estrone test successfully delineated this phase in 78% of menstrual cycles, and the ratio test, in 74%. The mean lengths of the derived fertile periods by both methods were 9.3 (SD 2.3) and 10.0 (SD 2.4) 24-hour periods (or days), respectively.

Adult↗
PubMed1988

Self-palpation to assess cervical changes in relation to mucus and temperature.

Women experienced in cervical self-palpation recognize fertile characteristics when the cervix is high, open, soft, and straight; this happens under estrogenic influence. The cervix is said to show infertile signs when it is low, closed, firm, and lying against the vaginal wall; that change occurs quickly under progesterone influence. The objective of this study was to assess the time relationship among changes in the cervix observed by self-palpation, changes in cervical mucus as observed by women, and the shift in basal body temperature during ordinary cycles. A total of 215 symptothermal charts from natural family planning users were analyzed. The duration of the change from the maximum fertility characteristics to the postovulatory return to definite signs of infertility was measured. This duration ranged from 1 to 7 days, with a mean of 2.65. The timing of maximum fertility signs in the mucus was compared with that of maximum fertility signs in the cervix: it varied from 3 days before to 6 days after, with a mean of 0.48 day. The timing of the first high temperature was compared with that of return to definitely infertile characteristics: it varied from 6 days before to 3 days after, with a mean of -0.69 day. Some of the variation may be due to the presence of inexperienced users in the sample. However, a mean difference of half a day between the most fertile cervix and the most fertile mucus on one hand and between the first day of infertile cervix and the first high temperature on the other hand suggest that the cervical changes could be useful indicators of estrogen and progesterone actions.

Adult↗
PubMed1988

Breast-feeding and natural family planning.

The records of 50 Australian postpartum women who intended to breast-feed for longer than 6 months were analyzed. Fifty percent of the women breast-fed longer than 12 months, and 50% resumed menses by 40 weeks after childbirth. Fifty-four women provided records of mucus and BBT for at least 4 weeks before resumption of menses. Ovulation before menses while fully breast-feeding was probable in only one woman. Fifty percent of the first postpartum cycles had a short luteal phase. Thirty-two women chose NEP to avoid pregnancy during the study period. Mucus and BBT proved to be a good marker of ovulation during postpartum cycles. The mean number of days available for intercourse according to the Ovulation Method was 22.6 days between 6 and 12 postpartum weeks, and 12 days during the 4 weeks before menses. Confidence in NFP during lactational amenorrhoea and first postpartum cycles is analyzed. Finally, research aimed at improving the teaching and use of NFP for postpartum breast-feeding women is described.

Adult↗
PubMed1988

Natural family planning and pregnancy outcome.

A prospective study with 664 married couples using a particular symptothermal method of natural family planning (NFP) offered the opportunity to investigate the relationship between NFP and the alleged risk of an increased incidence of spontaneous abortions and malformations. An analysis of 611 pregnancies with known outcome did not confirm such a risk. On the contrary, there was a trend toward fewer spontaneous abortions and malformations in our clients. This might be due to special care given to the beginning pregnancy as soon as it became evident.

Abortion, Spontaneous↗
PubMed1988

Analysis of the outcome of 124 pregnancies produced during NFP.

The outcome of 124 pregnancies produced during the use of CM (Billings) of NFP is analyzed. The spontaneous abortion rate was 8%. The women who became pregnant in the less fertile period (+/- 3 days from peak day) presented a higher rate of spontaneous abortions (13.9%) than the women who became pregnant during the most fertile period (peak day +/- 2 days), who presented a 4.3% spontaneous abortion rate. Among the 115 living infants (one twin pregnancy) there was one congenital malformation (0.8%), a cleft palate. The sex ratio of the infants was 0.59 (48 females and 67 males), which is not significantly different from the 0.51 sex ratio expected. When conception occurred during the most fertile period, the sex ratio was 0.37, in contrast to the sex ratio of 0.76 when conception occurred in the less fertile period; this is a highly significant difference (P less than 01).

Abortion, Spontaneous↗
PubMed1988

Natural methods for fertility control: a prospective study--First Part.

This study describes 4 years of verification of effectiveness and applicability of BBT and symptothermal methods. The couples chosen had to undergo a 6-month-long study phase, and be psychologically motivated and well trained in NFP. During this period, particular emphasis was given to the motivational factor, which was expanded in its anthropological, relational, pedagogical and, sometimes, moral contents. Four hundred and sixty couples entered the program, for a total of 8,140 cycles, in which BBT, cervical mucus, and intercourse were charted. The Pearl Index for unplanted pregnancies was 3.6. Twenty-five unplanned pregnancies occurred in couples using NFP for spacing, and no pregnancies were reported in limiters.

Adult↗
PubMed1988

The development of fertility assay kits: an overview.

This paper analyzes the importance of developing fertility assays kits, specially in order to shorten the estimate of the fertile period in NFP users. It presents the criteria that an assay kit needs to meet. Urinary hormones, metabolites of progesterone, estrogens, and luteinizing hormones are analyzed as fertile-period markers. Progesterone and estradiol in saliva, as well as other constituents of saliva, the volumetric vaginal aspirator, and the change in the electrical conductivity of the vaginal fluid are also analyzed with the same purposes.

Family Planning Services↗
PubMed1988

The natural family planning programme in Bangladesh.

A 12-month evaluation of the Ovulation Method of Natural Family Planning programme in Bangladesh is presented. Four hundred and forty-eight women entered the programme, 232 for spacing, 184 for limiting, and 32 to achieve pregnancy. Of the participating couples, 79% lived in rural areas and 20.3% were illiterate. The 416 who learned the ovulation method for avoiding pregnancy completed 2,358 months of use, with 14 unplanned pregnancies during the study period, which represents a pregnancy rate of 7.2 according to the Pearl Index. The discontinuation rate in the 12-month period was 2.4%.

Adolescent↗
PubMed1988

Demographic study on the family planning behaviour of the German population: the importance of natural methods.

A total of 1,267 women in the F.R.G., aged from 15 to 45 years, were interviewed about their family planning behavior and the importance of natural methods of family planning (NFP) in a representative demographic study. It was found that 19.6% of the respondents were not sexually active. The others used various methods, as follows: pill, 38.4%; IUD, 10.3%; condom, 5.9%; diaphragm, 2.1%; spermicides, 0.8%; withdrawal, 3.4%; NFP methods, 3.9%. The main reason for rejecting a method was a possible medical risk. Of the responding women, 73% had some previous knowledge about NFP; 47% of them found such methods to be interesting, and approximately 20% indicated a high probability of the use of NFP methods in the future.

Adolescent↗
PubMed1988

Factors affecting client satisfaction in the instruction and usage of natural methods.

A cross-sectional sample of women who had attended "at least one" instruction is utilized to assess dimensions of client satisfaction with instruction in and usage of natural family planning (NFP) methods (N = 440). Ovulation and symptothermal methods are represented by five autonomous programs in the state of Oregon. Psychosocial factors affecting experiences with natural methods are assessed using a mailed questionnaire yielding a 57% response rate and follow-up interviews with 28 couples from the initial sample. Findings yield an overall "effectiveness" rate of 94% for family-size limiters, and 88% for spacers. There was no difference in overall marital happiness between NFP users and discontinuers, although this may be more related to the overall high level of marital happiness for the total sample compared with the general population. Couples describe their perceptions of the effects of natural methods on marriage, communication patterns, sexual satisfaction, and family life. Implications for program development and research are explored.

Adult↗
PubMed1988

Acceptability of the modified mucus method: study of the psychosocial factors affecting acceptance.

A three-phase study designed to study the acceptability and use-effectiveness of the modified mucus method covered a sample of 2,601 poor rural migrant women living in eight low-income areas--villages and resettlement slum colonies. In phase I, the women were exposed to NFP awareness, i.e., the modified mucus method, and 61.6% of the women accepted the method, and agreed to learn and use it. The learning phase is three cycles. Of these acceptors, 83.7% were fertile. A large percentage of the acceptors are Hindus. The low acceptance by the Sikhs was who were non pregnant, menstruating cohabiting. 15.3% were nonmenstruating owing to pregnancy or breast feeding; 0.9% were menstruating, but not cohabitating; 35.4% of the women were not interested in learning or using the method. A comparative study of the acceptance and nonacceptance for the selected sociodemographic and family planning variables is analysed. The acceptors of NFP differed significantly from the acceptors of sterilization and IUD in their occupation, educational levels, duration of marriage, number of living children, number of living sons, knowledge of family planning, and previous use of family planning.

Cervix Mucus↗
PubMedDate not supplied

Changes in sialic acid concentration in human saliva during the menstrual cycle.

Salivary sialic acid concentration was studied daily in 20 fertile women during the menstrual cycle. The Warren method was used and plasma LH and BBT were also determined. The sialic acid concentrations in saliva throughout the cycle showed a peak 4 or 5 days before the LH preovulation surge. This maximal peak showed a mean of 10.89 +/- 1.11 mg%. This method may be useful for predicting the pre- and postovulatory fertile period.

Adolescent↗
PubMedDate not supplied

Changes in enzyme levels in human cervical mucus during the menstrual cycle.

Cervical mucus is a complex secretion produced by the endocervical epithelium. A comparative analysis of 30 enzymes was carried out on 15 women during their periovulatory period (days 10 to 16 of the menstrual cycle). Nine different enzymes were always found to be present in the cervical mucus. Changes in enzymatic activity were further studied in two of the women, one with a normal (27-day) and the other with a short (20-day) menstrual cycle. The data were compared with those for the same enzymes in the saliva of these two women. Each woman's ovulation time was determined through hormone measurements in urine and blood, as well as by recording basal body temperature and by Billing's method. Our results indicate that a maximum peak occurs for several enzymes during the periovulatory period.

Adult↗