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IMMUNOCHEMICAL DETECTION OF OVULATION.
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Detection of ovulation by color changes in cervical mucus of crab-eating macaque (Macaca fascicularis).
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Sodium chloride content of cervical mucus and its use in detection of ovulation.
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The accuracy of urinary luteinizing hormone testing in predicting ovulation.
Transvaginal ultrasonography and daily urinary luteinizing hormone testing were used to evaluate the accuracy of urinary luteinizing hormone testing in predicting ovulation in 33 spontaneously ovulating women beginning on cycle day 10. Ovulation was confirmed in all patients with luteal phase progesterone levels and endometrial biopsy specimens. The results demonstrated that transvaginal ultrasonography and urinary luteinizing hormone testing detected ovulation in all cycles. However, the onset of urinary luteinizing hormone occurred after follicle rupture was documented by ultrasonography in 9% of the women studied. Thus the question of accuracy of urinary luteinizing hormone testing in prediction contrasted to detection of ovulation is raised. This observation is of importance in patients in whom prediction of ovulation is critical to treatment management. Therefore, an ultrasonographic examination to confirm the presence of an unruptured follicle on the day of onset of urinary luteinizing hormone surge is recommended, particularly in patients failing to conceive after three to six cycles of artificial insemination when the inseminations are timed with the onset of urinary luteinizing hormone surge.
A new diagnostic aid for natural family planning.
INTRODUCTION: We have studied the use-effectiveness of salivary ferning as a diagnostic testing aid to natural family planning. We used PG/53, a pocket microscope. MATERIALS AND METHODS: Use of natural family planning methods was studied in 32 women who used the new technology PG/53 to detect the fertile period. By this means the women observed their menstrual cycles and other markers of fertility, such as basal body temperature and appearance of cervical mucus. RESULTS: Of the 32 women participating in this research, 28 women had a good salivary test with positive ferning by the microscope in the same period as other markers of fertility. In 4 cycles the ferning was uninterpretable as there was no correspondence with the cycle phase. Ferning began 1-2 days before cervical mucus appearance, and lasted a mean of 6.2 days. Ferning occurred, on average, 7.2 days before the first day of temperature shift. CONCLUSIONS: There is a direct correlation between salivary ferning and fertile period. Salivary ferning may be used as a new parameter to aid women to detect the fertile period in combination with other symptothermal methods of ovulation detection. We now need further research in order to improve the use-effectiveness of salivary ferning.
Milk and serum progesterone levels in mares after ovulation.
Twenty-four Finnhorse mares were examined by rectal palpation and ultrasonography every 6 h during late oestrus to determine the time of ovulation. Milk and serum samples were collected every 6 h after the detected ovulation for progesterone analysis. The progesterone rises took place within 0-54 h and 0-60 h after ovulation, in milk and serum, respectively. Statistically significant differences (p less than 0.05) in progesterone levels were observed for the first time 12-18 h and 18-24 h after ovulation, in serum and milk, respectively, as compared to progesterone levels 0-6 h after ovulation.
The temporal relationship between vaginal fluid volumes obtained with the Rovumeter vaginal aspirator and the fertile phase of the cycle.
Recent trends in family planning demonstrate an increasing interest in natural methods of birth regulation. In their present form, however, these methods are highly subjective and individualistic. A further trend in fertility programmes has been a very rapid development of technological methods to detect fertility in the female cycle, some of which could possibly benefit natural family planning users. One such technique--that of changing volumes of cervico-vaginal fluid (CVF), which is a mixture of cervical mucus and vaginal transudate--has been tested in a pilot study to ascertain its reliability to demarcate the fertile phase of the cycle. Results show that in all cycles tested, it is possible using the Rovumeter aspirator to detect the beginning of the fertile phase by rapidly increasing volumes of CVF; this volume reaches a peak approximately 1 day before ovulation detected by ultrasound and demonstrates an abrupt fall after ovulation and the onset of the infertile phase. From the results of this pilot study, we believe that, by the use of suitable algorithms and larger studies, it should be possible to develop a CVF volume method which could be offered as an objective alternative method for users of natural family planning and programmes.
[How do self-observed cycle symptoms correlate with ovulation?].
The symptoms of self-observation of the menstrual cycle (basal body temperature, mucus symptom, autopalpation of the cervix) are often regarded as not reliable for ovulation detection. In a prospective study 87 NFP cycles are monitored additionally with ultrasound and LH tests to calculate the correlation of the ovulation-time with the symptoms of self-observation. Our results show that the symptoms of self-observation allow a reliable detection of the time of ovulation. Only a short introduction into the method of self-observation is a necessary precondition. The reliable detection of ovulation gives the opportunity of cycle analysis of large groups especially in long time investigations. In this way a large set of valuable and reliable data on normal and disturbed menstrual cycles will be available.
Effect of oestrous synchronization with estradiol 17beta and progesterone on follicular wave dynamics in dairy heifers.
An experiment was designed to evaluate the effects of estradiol-17beta (E17beta) on follicular wave dynamics and ovulatory response in Holstein heifers receiving either a progestogen ear-implant (Crestar; Intervet International b.v. Boxmeer, The Netherlands) or an intravaginal progesterone-releasing device [controlled internal drug release-bovine device (Eazibreed, CIDR-B; Bodinco BV, Alkmaar, The Netherlands)]. For comparison, another group of heifers was also synchronized using Crestar plus an injection of estradiol valerate (EV) and norgestomet as recommended by the pharmaceutical company. Twenty 20-22-month-old cycling Holstein heifers were allocated to one of the following treatment groups at random stages of the oestrous cycle: (I) simultaneous insertion of Crestar and intramuscular injection of 3 mg norgestomet and 5 mg EV (Crestar 9 + EV 9); (II) simultaneous insertion of Crestar and intramuscular injection of 5 mg E17beta (Crestar 9 + E17beta 9); (III) insertion of Crestar followed 2 days later by intramuscular injection of 5 mg E17beta (Crestar 9 + E17beta 7); or (IV) insertion of CIDR-B device followed 2 days later by intramuscular injection of 5 mg E17beta (CIDR 9 + E17beta 7). The CIDR-B or Crestar implants were removed after 9 days and all heifers received 500 microg Cloprostenol (Estrumate, Pitman-Moore Nederland BV, Houten. The Netherlands). Ovarian ultrasonographic examinations were performed once daily during the synchronization period using a B-mode scanner equipped with a 7.5 MHz linear-array transrectal transducer. In addition, heifers were scanned every 12 h after implant/device withdrawal until 3 days after ovulation in order to monitor follicular activity, detect ovulation and subsequent early luteal formation. Detection of oestrus was performed every 6 h for 4 days after device/implant removal. Oestrus was observed 24-32 h before ovulation in all heifers. The mean hours interval from treatment withdrawal to ovulation was not significantly different (84.0 +/- 16.5, 77.6 +/- 4.1, 73.6 +/- 4.1 and 64.0 +/- 4.4 h for treatments I, II, III and IV, respectively, p > 0.1). However, the variance for heifers treated with EV + norgestomet was significantly larger (Levene's Test; p < 0.01) than those treated with E17beta. All E17beta treatments resulted in dominant follicle suppression and a new wave emerged 4.1 days after treatment compared with 6.6 days for the EV + norgestomet treatment (p < 0.05). The time from emergence of the new ovulatory wave to ovulation was longer for the new wave that emerged after E17beta treatment (9.2 +/- 0.3 days) than after EV + norgestomet treatment (6.9 +/- 0.4 days; p < 0.05). The results of this study suggest that the four treatments used were effective in inducing synchronous behavioural oestrus and ovulation. However, a higher degree of oestrus and ovulation synchrony was observed in heifers treated with E17beta than in heifers treated with EV + norgestomet. Synchronization treatments with exogenous E17beta or EV + norgestomet at the time of progestin device insertion (Crestar or CIDR-B) or 2 days later in heifers can regulate a different emergence pattern of ovarian follicular development in randomly cyclic heifers. The E17beta was effective in inducing follicular suppression and resulted in the consistent emergence of a new follicular wave.
The more accurate timing of insemination with regard to ovulation does not create a significant improvement in pregnancy rates in a donor insemination program.
OBJECTIVE: To determine if the accurate prediction of ovulation before artificial insemination of frozen donor semen was justified by increased pregnancy rates. DESIGN: A retrospective study of inseminations, over a 2-year period, administered to women who were enrolled on a donor insemination program and who were monitored using one of four ovulation timing regimens. Also, a study of the significance of follicle status at the time of insemination with relevance to pregnancy was carried out. SETTING: A university teaching hospital donor insemination program. PATIENTS: Patients entered in this study were undergoing insemination with thawed, cryopreserved, donor semen. MAIN OUTCOME MEASURES: Pregnancy and follicle status at the time of insemination. RESULTS: There was no statistically significant difference in pregnancy rates between the four methods of ovulation detection most commonly used for artificial insemination. Inseminations several hours either side of ovulation did not result in a significantly different pregnancy rate than inseminations carried out closer to ovulation. CONCLUSION: More accurate and expensive methods of detecting changes in ovulation result in no significant increase in fecundity than other less expensive timing techniques.
[Natural family planning (symptothermal method) and objective ovulation parameters--a pilot study].
This pilot study involved 20 cycles contributed by six apparently healthy women. They were all experienced users of the symptothermal method of NFP and trained as NFP-teachers. In a double-blind study NFP-parameters like S-19 = F1, appearance of any mucus = F2 and appearance of fertil mucus = F3 also peak mucus symptom +4 = L1 and 3. day of high basal body temperature = L2 are related to ovulation detected by ultrasonic measurement of follicular growth and hormonal values (LH, total Oestrogen in urine). We have focused on the calculation of the first day and the end of the fertile phase. In relation to the maximal follicular diameter (mfd = day 0) the LH-peak was located at day -0,7. The peak mucus symptom was observed at day -0,58. F1 was seen 10,4 +/- 2,6 days, F2 6,2 +/- 2,6 days, F3 2,8 +/- 1,4 days before day 0. L1 was located at 3,37 +/- 1,74 days, L2 4,1 +/- 1,95 days after day 0. Using at least 2 indicators as recommended with the symptothermal method none of 19 cycles failed to detect the beginning of the fertile phase, but 3 out of 20 failed to detect the end. In 19 out of 20 cycles natural signals observed by the participants indicated ovulation. It must be mentioned that all our women were highly motivated persons.
Occult abortion: not a major cause of infertility.
OBJECTIVES: To determine whether occult abortion is a frequent cause of infertility. DESIGN: Prospective observational clinical study. SETTING: Hospital based infertility clinic, serving as the only primary infertility care facility to a population of 250,000 people. PATIENTS: 102 subsequent infertility patients. INTERVENTIONS: Ultrasound ovulation detection, timed hCG determinations. MAIN OUTCOME MEASURE: Proportion of patients with serum hCG levels > 2.0 mIU/mL (> 2.0 IU/L) on days 12 or 13 after ultrasound-proven ovulation with subsequent appearance of the menstrual period before or at postovulation day 14. RESULTS: In 18 of 102 patients increased hCG was found. All these patients became clinically pregnant (9 spontaneous abortions, 9 ongoing pregnancies). No occult abortion occurred (95% confidence interval 0-4%). CONCLUSIONS: Occult abortion is not a frequent cause of infertility in an unselected population.
Reliability of ovulation tests in infertile women.
OBJECTIVE: To assess the reliability of the most widely used clinical methods for predicting or confirming ovulation. METHODS: We monitored spontaneous cycles in 101 infertile women using basal body temperature (BBT), transvaginal ultrasound, a urinary stick system for LH surge, and three serum progesterone measurements in the midluteal phase. Transvaginal ultrasound monitoring was standard for ovulation detection and sensitivity. We calculated specificity and accuracy of each method compared with that standard. RESULTS: Follicular development and ultrasound evidence of ovulation were confirmed in 97 of 101 cycles (96%). Urinary LH surge preceded follicular rupture assessed by ultrasonography in all cycles and showed concordance with ultrasound-evidenced ovulation in 98 of 101 cases. The timing of BBT nadir had wide variability, and BBT and ultrasonography agreed in a similar percentage of cases (74%). Midluteal serum progesterone assessments showed ovulatory values in 93 subjects, and ovulation was concordant with ultrasonography in 90 subjects. CONCLUSION: Urinary LH was accurate in predicting ovulation with ultrasonography as the standard for detection, but time varied widely. The nadir of BBT predicted ovulation poorly. The BBT chart was less accurate for confirming ovulation, whereas a single serum progesterone assessment in midluteal phase seemed as effective as repeated serum progesterone measures.
Ovulation timing by a radioreceptor assay for human luteinizing hormone.
Since predetermination of ovulation would be helpful in treatment of sterility, a quick, sensitive, and specific radioreceptor assay (RRA) for measurement of actual LH concentrations in human serum has been developed. Using partially purified membrane receptors from bovine testes, our assay system enabled precise measurement of LH within 4 hours. The detection limit of the present method is 0.78 ng LER 960/ml serum. The method was used to detect ovulation during four observation cycles each in eleven women who were undergoing treatment for infertility, such as recommended intercourse or artificial insemination because of reduced fertility of their husbands. In all women ovulations could be predicted by LH surge and were verified by laparoscopy within 36 hours. Insemination was carried out at the time of the characteristic increase of LH values around mid-cycle. Pregnancy occurred in three women during the observation period.
Detection of oestrus in dairy cows: a new approach to an old problem.
Fertility indices, such as non-return rate and number of services per conception, have worsened significantly over the past few years. Because oestrus detection is one of the major factors influencing these indices, this study was performed to determine whether, how long, and at what time dairy cows show signs of oestrus in their behaviour. Two high producing herds with about 40 open cows were observed for 30 minutes every 2 hours for 6 weeks. The various signs of oestrus were recorded. The milk progesterone concentration was monitored daily to detect ovulation. A scale (Table 2) was composed according to the frequency of these symptoms during and between oestrous periods. This scale was used in order to determine which cows were in oestrus. Each oestrous symptom was given a score and the scores were summed for a 24-hour period. If a score of > 100 points was reached within a 24-h period, the cow was considered to be in oestrus. As used, the oestrus detection scale proved to be very convenient. Because standing oestrus was observed in only 37% of the oestri, this criterion had a very low sensitivity for oestrus detection. With the use of this scale and 12 observations per day, we reached a detection rate of 100%. If a more practical observation scheme would have been used (e.g. observing the herd twice daily, for 30 min) lower threshold values would have been obtained. This observation scheme resulted in a detection rate of 74% with no incorrect assessments.
Timing of ovulation for AIH with freeze-thawed, subfertile sperm: two case studies.
Two couples were studied in whom the male partner had become sterile due to irradiation therapy given for advanced Hodgkin's disease. Both couples achieved conception during the first and second treatment cycle, respectively, despite obviously subfertile freeze-thawed sperm. The success is attributed to optimal timing of a single homo-insemination (AIH), which was made possible because we could detect ovulation by using currently available sophisticated methods. The importance of precise timing of ovulation for insemination and the ability to retain fertilizing capacity of young males with compromised sperm, who underwent sterilizing treatment, is discussed.
[Variations in the body temperature of cows during oestrus (author's transl)].
The temperatures of twenty cows were recorded rectally from five days prior to the expected date of oestrus till after ovulation at 2.30, 7 and 12 a.m. and at 5 and 10 p.m. The cows were also examined for oestrus behaviour at these times. When the cows had stood to be mounted for the first time at one of the hours of observation, the ovaries were examined by palpation at the subsequent times to detect ovulation. The total number of cows in heat, in which marked oestrous behaviour was observed, was forty-one. In addition, there were eight cases of silent oestrus, i.e. though the animals did ovulate and usually showed an increase in temperature, they did not stand to be mounted. Variance analysis showed that de 'cow effect', the time of day, the stage of oestrus, the oestrus number and the interaction of the stage of oestrus and the time of day had a significant effect on the body temperature. In 86 per cent of the cases of oestrus (including those of 'silent oestrus'), there was a significant increase in body temperature. This proportion was much smaller, namely 55 per cent, when observations were made about milking time only (7 a.m. and 5 p.m.). The mean difference between the highest temperature during oestrus and the average reference temperature was 0.62 degrees C +/- 0.38 degrees C. Daily monitoring of the temperature was also found to be useful in checking the state of health of the dairy herd.