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Results of the first 1000 radioreceptorassays for the determination of human chorionic gonadotropin: a new, rapid, reliable, and sensitive pregnancy test.

One thousand radioreceptorassays for human chorionic gonadotropin (hCG) for the diagnosis of pregnancy were analyzed under eight categories. The high sensitivity (50 pg/ml) and specificity, coupled with performance time of the assay (1 hour), provided a new modality for the early diagnosis and management of normal and abnormal pregnancy in the first trimester. The radioreceptorassay becomes positive 1 week after conception. In the normal pregnancy this assay has been 100% correct at the time of the first missed menses. All ectopic pregnancies demonstrated positive tests, and no false negatives occurred. On the other hand, a negative assay excluded ectopic pregnancy.

Abortion, Incomplete↗

Studies on the pattern of circulating steroids in the normal menstrual cycle. 2. Levels of 20alpha-dihydroprogesterone, 17-hydroxy-progesterone and 17-hydroxypregnenolone and the assessment of their value for ovulation prediction.

Plasma levels of 20alpha-dihydroprogesterone, 17-hydroxyprogesterone and 17-hydroxypregnenolone were assayed daily in 15 normally menstruating women during a complete menstrual cycle. In order to ascertain the normalcy of the cycles studied, LH, progesterone and oestradiol were also determined daily. The pattern of 20alpha-dihydroprogesterone was very similar to that of progesterone. The levels found during the proliferative phase (around 240 pg/ml) increased significantly on the day of the LH-surge and reached values of approximately 3.7 ng/ml at the peak period of luteal activity. The plasma levels of 17-hydroxyprogesterone in the proliferative phase were around 380 pg/ml. The first significant increase occurred one day before the LH-surge and was followed by a sharp peak (approximately 1.5 ng/ml) which coincided with the LH peak. A significant decrease occurred after this peak, which reached a nadir two days after the LH-surge. This was followed by a second rise with a rather broad peak (about 1.8 ng/ml) around the 5th to 7th days after the LH-surge. The levels of 17-hydroxypregnenolone did not show any cyclic variation: from all figures a geometric mean value of 1.62 ng/ml was calulated with tolerance limits at 0.241 and 10.8 ng/ml. Individual day-to-day changes in steroid levels were assessed with regard to their potential for the early identification of the day of the LH-surge. A 17-hydroxyprogesterone value of 1.0 ng/ml, or more, was seen for the first time in the cycle on the day of the LH peak in 13 cycles and a progesterone + 17-hydroxyprogesterone level of at least 1.8 ng/ml in 14 of the 15 cycles studies. These data seem to warrant a study of the predictive value of progesterone and 17-hydroxyprogesterone assays in a much larger population.

17-alpha-Hydroxypregnenolone↗

Occult pregnancy. A pilot study.

As used herin, the term "occult pregnancy" is defined as a pregnancy which aborts so early that no clincial suspicion of its existence arises except perhaps that there has been a few days' delay in the onset of an otherwise normal menstrual period. Sixteen Clomid-induced ovulatory cycles as evidenced by biphasic temperature charts with hyperthermic phases of 12 days or more were studied. Of these, 10 had serum luteinizing hormone values in the late luteal phase normal for that part of the cycle (6-16 mIU/ml) and six, or 37.5% showed values sufficiently elevated (more than three standard deviations) to indicate a cross reaction with human chorionic gonadotropin and hence the presence of an otherwise unsuspected pregnancy. All had clinically normal menstrual periods 12 hours to 6 days later. The clinical significance of this finding is discussed.

Abortion, Spontaneous↗

Temporal relationship between basal body temperature nadir and luteinizing hormone surge in normal women.

Basal body temperature (BBT) as a predictor of ovulation was assessed by examining the temporal relationship between the BBT shift and the luteinizing hormone (LH) surge in individual cycles of 27 normal women. For 22 of the subjects, the LH surge occurred on the same day or within one day of the BBT nadir. For the remaining five subjects, the surge fell within 2 days after or 3 days before the nadir. Despite the BBT nadir's close temporal association with the LH surge, daily examination of BBT for the purpose of predicting the day of ovulation during a given cycle is unsatisfactory. By 48 hours following the nadir, when one could usually be certain that temperature elevation had occurred, all subjects had already exhibited the LH surge.

Adult↗

Creighton Model NaProEducation Technology for avoiding pregnancy. Use effectiveness.

OBJECTIVE: To evaluate the use effectiveness of Creighton Model (CrM) NaProEducation Technology for avoiding pregnancy. STUDY DESIGN: CrM is a medical model of natural procreation education that is a fully standardized modification of the Billings ovulation method. This system has been used as a means to avoid pregnancy and has been prospectively evaluated in five use effectiveness studies. A prospective life-table analysis of the five studies (meta-analysis) was undertaken, yielding both net and gross rates. Discontinuation rates were also calculated. These studies were conducted at CrM centers in Omaha, St. Louis, Wichita, Houston, and Milwaukee. RESULTS: A total of 1,876 couples used CrM NET for a total of 17,130.0 couple months of use. The method and use effectiveness rates for avoiding pregnancy were 99.5 and 96.8 at the 12th ordinal month and 99.5 and 96.4 at the 18th ordinal month, respectively. The discontinuation rate was 11.3% at the 12th ordinal month and 12.1% at the 18th ordinal month. CONCLUSION: CrM is highly effective as a means of avoiding pregnancy in both its method and use effectiveness. The method effectiveness has remained stable over the years of the studies, but the use effectiveness for avoiding pregnancy appears to have improved over the study period.

Adult↗

The significance of serum oestradiol and progesterone levels in evaluating the response to clomiphene citrate.

In practice, the prediction of ovulation after the administration of clomiphene citrate (Clomid) has been based on measurement of biphasic basal body temperature and menstrual changes. In this article a protocol is presented to gauge adequately the extent of the response to the drug and to monitor reliably the occurrence of ovulation. The measurement of oestradiol levels at two different times, coupled with a single progesterone estimation, has proved the method of choice in monitoring Clomid response. These assays may provide reliable criteria for establishing suitable doses for individual patients.

Adolescent↗

[Studies on biotechnical ovulation synchronization in young sows. 3. Report: ovulation onset, ovarian findings and results of fertilization after metallibur, 750 IU PMS, with and without 500 IU HCG with varied treatment time].

Fourty-eight gilts were treated with Turisynchron-Prämix (Turi.) and PMS (750 IU; 24-hours a. Turi.). One-half of the animals receaved additionally 500 IU HCG (fourth day a. Turi.). Performing treatments (Turi., PMS, HCG) either between 8 and 9 a.m. or 3 and 4 p.m. resulted in 2 experimental (HCG) and 2 control (without HCG) groups, each consisting of 12 animals. Double insemination took place according to treatment times at the fifth or the fifth and sixth day a. Turi. The experimental animals underwent laparotomy at the sixth day between 9 and 12 a.m., the conerols between 1 and 4 p.m. at the sixth or 9 and 12 a.m., at the seventh day a. Turi. Oviducts were flushed either at laparatomy or on slaughter to establish fertilization. From 24 experimental animals 20 ones had ovulated between 42-53 h p. HCG, and at slaughter 22 did so. The period of ovulation is mainly assumed near and immediately after 42 h p. HCG. In controls ovulation could be established in 3 of 15 animals laparotomized up to 152 h a. Turi. and in 8 of 9 animals laparotomized up to 168 h a. Turi. At slaughter there were in all 22 animals of the 2 control groups which had ovulated. In the rate of ovarian cysts (25-33%) and fertilized ova no remarkable differences were found between the groups.

Animals↗

Pedometer readings for estrous detection and as predictor for time of ovulation in dairy cattle.

The objective of this study was to study the relationship between increase in number of steps measured by pedometers, behavioral estrous parameters and time of ovulation, in order to investigate whether the number of steps can be used as a tool for estrous detection and as a predictor for time of ovulation. In total, 63 ovulations were observed in 43 Holstein-Friesian cows. Different behavioral signs of estrus were observed at 3h intervals. Cows were equipped with pedometers, which stored number of steps in 2h time periods and pedometer estrus alerts were defined using different algorithms and thresholds. The percentage of behavioral estruses also detected by pedometers measurements, ranged between 51 and 87% for all estrous periods. When only estrous periods where taken into account in which more than one animal was in estrus, detection percentages increased up to 95%. Number of steps taken during the estrous period was higher when more animals were in behavioral estrus at the same time, and number of steps taken during the estrous period was also higher for primiparous cows compared to multiparous cows. Ovulation occurred 29.3+/-3.9h after onset of increased number of steps (ranging between 39 and 22 h) and 19.4+/-4.4h after the end of increased number of steps (ranging between 35 and 12h). The intervals were not influenced by the number of animals that were in estrus at the same time or by parity. In conclusion, pedometers can detect estrus accurately and appear to be a promising tool for prediction of ovulation and hence could be a tool for improving fertilization rates.

Algorithms↗

The temporal relation between the urine LH surge and sonographic evidence of ovulation: determinants and clinical significance.

OBJECTIVES: 1) To define the temporal relation between self-detection of the urine LH surge and sonographic evidence of ovulation, 2) to identify clinical factors that affect this interval, and 3) to determine whether differences in the day of sonographic detection of ovulation could potentially influence pregnancy rates during timed supracervical insemination cycles. METHODS: Two hundred sixty-nine cycles in 145 women treated in an infertility center were analyzed. The subjects were referred for urine LH-timed supracervical insemination and were managed prospectively by protocol, including transvaginal sonographic confirmation of ovulation. Unstimulated and clomiphene citrate cycles were studied. RESULTS: Sonographic evidence of ovulation was detected by the first day after the urine LH surge (day +1) in 95 cycles (35%, 95% confidence interval [CI] 29-41) and not until day +2 in 165 cycles (61%, 95% CI 55-67). Further analyses indicated that cycles with two or more ovulations were associated with a significantly greater percentage of cases in which ovulation was not demonstrated until day +2 (81%, 95% CI 76-86) compared with mono-ovulatory cycles (52%, 95% CI 46-58) (P < .001). Multivariate analysis revealed that the day of sonographic detection of ovulation was linked with clinical pregnancy rates during these insemination cycles (P < .05). CONCLUSIONS: A substantial number of women, especially those with multiple ovulations, will not demonstrate sonographic evidence of ovulation until the second morning after detection of the urine LH surge. This temporal relation may exert an impact on pregnancy rates during supracervical insemination cycles.

Adult↗

The effects of different insemination regimes on fertility in mares.

This study investigated the effects of different artificial insemination (AI) regimes on the pregnancy rate in mares inseminated with either cooled or frozen-thawed semen. In essence, the influence of three different factors on fertility was examined; namely the number of inseminations per oestrus, the time interval between inseminations within an oestrus, and the proximity of insemination to ovulation. In the first experiment, 401 warmblood mares were inseminated one to three times in an oestrus with either cooled (500 x 10(6) progressively motile spermatozoa, stored at +5 degrees C for 2-4 h) or frozen-thawed (800 x 10(6) spermatozoa, of which > or =35% were progressively motile post-thaw) semen from fertile Hanoverian stallions, beginning -24, -12, 0, 12, 24 or 36 h after human chorionic gonadotrophin (hCG) administration. Mares were injected intravenously with 1500 IU hCG when they were in oestrus and had a pre-ovulatory follicle > or =40mm in diameter. Experiment 2 was a retrospective analysis of the breeding records of 2,637 mares inseminated in a total of 5,305 oestrous cycles during the 1999 breeding season. In Experiment 1, follicle development was monitored by transrectal ultrasonographic examination of the ovaries every 12 h until ovulation, and pregnancy detection was performed sonographically 16-18 days after ovulation. In Experiment 2, insemination data were analysed with respect to the number of live foals registered the following year. In Experiment 1, ovulation occurred within 48 h of hCG administration in 97.5% (391/401) of mares and the interval between hCG treatment and ovulation was significantly shorter in the second half of the breeding season (May-July) than in the first (March-April, P< or =0.05). Mares inseminated with cooled stallion semen once during an oestrus had pregnancy rates comparable to those attained in mares inseminated on two (48/85, 56.5%) or three (20/28, 71.4%) occasions at 24 h intervals, as long as insemination was performed between 24 h before and 12 h after ovulation (78/140, 55.7%). Similarly, a single frozen-thawed semen insemination between 12 h before (31/75, 41.3%) and 12 h after (24/48, 50%) ovulation produced similar pregnancy rates to those attained when mares were inseminated either two (31/62, 50%) or three (3/9, 33.3%) times at 24 h intervals. In the retrospective study (Experiment 2), mares inseminated with cooled semen only once per cycle had significantly lower per cycle foaling rates (507/1622, 31.2%) than mares inseminated two (791/1905, 41.5%), three (464/1064, 43.6%) or > or =4 times (314/714, 43.9%) in an oestrus (P< or =0.001). In addition, there was a tendency for per cycle foaling rates to increase when mares were inseminated daily (619/1374, 45.5%) rather than every other day (836/2004, 42.1%, P = 0.054) until ovulation. It is concluded that under conditions of frequent veterinary examination, a single insemination per cycle produces pregnancy rates as good as multiple insemination, as long as it is performed between 24 h before and 12 h after AI for cooled semen, or 12 h before and 12 h after AI for frozen-thawed semen. If frequent scanning is not possible, fertility appears to be optimised by repeating AI on a daily basis.

Animals↗

Concomitant secretion of Schwangerschaftsprotein 1 and human chorionic gonadotrophin following conception.

Daily measurements of serum oestradiol, progesterone, Schwangerschaftsprotein 1 (SP1) and hCG were made in 13 menstrual cycles during which conception occurred. The assays were continued until 21 d after ovulation. SP1 was detected in maternal blood 8-14 d after ovulation and hCG 9-13 d after ovulation. We conclude that these two proteins are secreted simultaneously but independently by the syncytiotrophoblast.

Chorionic Gonadotropin↗

The relation between ultrasonographic observations in the oviduct and plasma progesterone, luteinizing hormone and estradiol during the egg laying cycle in ostriches.

In this study we investigated the temporal relationship between ovulation, egg formation, oviposition and the changes in plasma concentrations of progesterone, luteinizing hormone and estradiol-17beta during the egg laying cycle in farmed ostriches. In 10 egg-producing birds, transcutaneous ultrasound scanning was performed at 3h intervals and blood sampling at hourly intervals during a period of at least 48h (one egg laying cycle). In hens (n=8) that ovulated during the observational period, the ovulated egg was first detected 2h after oviposition; thus, ovulation occurred shortly after oviposition in all birds. During the period between two consecutive ovipositions, the developing egg remained for 9h in the proximal part (infundibulum, magnum or isthmus) and for 39h in the distal part of the oviduct (uterus). In ovulating hens, plasma progesterone concentrations showed a characteristic and consistent profile: from basal levels of around 0.1ng/ml concentrations started to increase 12h before oviposition, reached an average maximum of 3.5ng/ml at 3h before oviposition and returned to basal levels 3h and 30min after oviposition. Changes in plasma luteinizing hormone and estradiol-17beta concentrations showed comparable patterns of elevation and decline relative to the timing of oviposition and ovulation. However, variation in their individual basal concentrations was generally larger and peak values were less conspicuous than those of progesterone. In non-ovulating hens (n=2) neither progesterone, nor luteinizing hormone nor estradiol-17beta showed elevations to peak concentrations before oviposition. These data demonstrate that during the egg laying cycle of ostriches, events such as ovulation, egg development and oviposition evolve according to a rather strict time schedule, and that progesterone, luteinizing hormone and estradiol-17beta reach peak concentrations shortly before ovulation. Additionally, our findings also show that on-farm ultrasound scanning is a useful technique to discriminate between ovulating and non-ovulating hens.

Animals↗