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PubMed1992

Methods of monitoring menstrual function in field studies: efficacy of methods.

Efficacy of methods for monitoring female reproductive potential under field study conditions was evaluated. Women (n = 10) were recruited to participate for two menstrual cycles on the bases, in part, of not seeking fertility assistance, working full-time but not in the medical field, and having less than one year of college education. Luteinizing hormone (LH), estrone-3-glucuronide, and pregnanediol-3-glucuronide were measured in daily morning urine and normalized to creatinine concentrations. These urinary measures were parallel to serum LH, estradiol, and progesterone profiles. Based on these urinary measures, 6 of 19 cycles were judged to be atypical. Transvaginal ultrasonography provided insights into ovarian activity during the atypical cycles. Of 13 LH surges detected by radioimmunoassay, 7 were not detected by a semiquantitative dipstick (OvuSTICK), perhaps due to that method's sensitivity to loss of LH immunoactivity caused by sample freezing. While intervals from salivary and vaginal mucous electrical resistance signals to the LH surge during typical cycles were similar to those reported previously, they were not predictive of ovulatory status during atypical cycles. Fifty-three percent of the cycles were misclassified on the basis of the basal body temperature rise. Cervical mucous color, amount, and consistency were not predictive of ovulation under these study conditions. The results from these 19 menstrual cycles provide information about the efficacy of various methods for characterizing menstrual function under field study conditions. In this regard, urinary endocrine measures are the most informative or practical.

Adult↗
PubMed1995

Fluoxetine increases resting energy expenditure and basal body temperature in humans.

Humans lose weight when administered fluoxetine, an inhibitor of serotonin reuptake by nerve terminals. To determine whether increased energy expenditure contributes to this weight loss we admitted 20 nondepressed obese women to a metabolic unit where they were randomly assigned to 3 wk of a 1.76-MJ/d formula diet and either 60 mg fluoxetine/d or a placebo. Resting energy expenditure of the control subjects fell below normal after 5.6 +/- 0.6 d of energy restriction, whereas that of the fluoxetine-treated subjects increased by 4.4 +/- 1.8% (P < 0.005) within 3 d of commencing treatment. This increased resting energy expenditure then reversed and fell below normal after 9.8 +/- 0.9 d of energy restriction. Basal body temperature of the control subjects decreased insignificantly during the period of energy restriction, but that of the fluoxetine-treated subjects increased by 0.28 +/- 0.10 degrees C (P < 0.05) within 3 d of commencing diet and drug treatment. Urinary norepinephrine excretion and the serum triiodothyronine concentration decreased equally in both groups. Despite identical energy intakes and equal nitrogen balance, the fluoxetine-treated subjects lost weight faster than the control subjects during the final week of energy restriction (P < 0.05). We propose that serotonin reuptake inhibition increases energy expenditure by increasing basal body temperature.

Adult↗
PubMed1994

Clinical evaluation of luteal function.

OBJECTIVE: To determine the ability of luteal phase length determined by basal body temperature (BBT) pattern and a midluteal serum progesterone level to predict the result of an endometrial biopsy in a subsequent cycle. METHODS: We performed a retrospective analysis of 141 women with a history of infertility who were being evaluated for luteal function. The luteal phase length determined from a BBT chart of one menstrual cycle was compared to a single midluteal serum progesterone level from a second menstrual cycle. These findings were compared to a luteal phase endometrial biopsy performed in a third menstrual cycle. Subjects were divided into four groups depending upon luteal phase length (normal 11 or more days) and serum progesterone level (normal at least 10 ng/mL). The four groups were designated "normal," "short luteal phase," "low progesterone," and "abnormal," depending upon the results of the two tests. The frequency of in- and out-of-phase endometrial biopsy results in the four groups was compared. RESULTS: There was no difference in the occurrence of an in- or out-of-phase endometrial biopsy when the four groups were compared. CONCLUSION: Neither luteal phase length nor a single midluteal serum progesterone level was predictive of subsequent in-phase or out-of-phase endometrial biopsy.

Adult↗
PubMed1993

Tympanic thermometry for recording basal body temperatures.

Evaluation of 12 menstrual cycles using oral, rectal, and TM temperature measuring devices (over 2,000 individual readings) confirmed the ovulatory thermal shift was equally detected with TM thermometry compared with the traditional methods. Although a single TM reading was satisfactory, an average of three successive readings provided a smoother graph (decreased variance). The device appears acceptable, and even preferred, for recording BBT charts, primarily because of its nearly instantaneous readings.

Adolescent↗
PubMed1978

Detection of ovulation by a method of change in finger-finger electropotential readings.

The purpose of this study was to determine whether ovulation can be detected by using a device (OvultronR) that measures electropotential differences in finger-to-finger contact. Daily basal body temperatures and five consecutive readings on the OvultronR were obtained each morning in 34 women for a three-month period. During one cycle an endometrial biopsy was taken and dated to document the time of ovulation. Our results showed that in only five out of 104 cycles did the device show an isolated change at the time of ovulation. This device is not a reliable method either for prediction of or the detection of ovulation. Therefore, one cannot effectively use this device alone as a basis for a rhythm method of contraception.

Adult↗
PubMedDate not supplied

Livebirth after orthotopic transplantation of cryopreserved ovarian tissue.

BACKGROUND: The lifesaving treatment endured by cancer patients leads, in many women, to early menopause and subsequent infertility. In clinical situations for which chemotherapy needs to be started, ovarian tissue cryopreservation looks to be a promising option to restore fertility. In 1997, biopsy samples of ovarian cortex were taken from a woman with stage IV Hodgkin's lymphoma and cryopreserved before chemotherapy was initiated. After her cancer treatment, the patient had premature ovarian failure. METHODS: In 2003, after freeze-thawing, orthotopic autotransplantation of ovarian cortical tissue was done by laparoscopy. FINDINGS: 5 months after reimplantation, basal body temperature, menstrual cycles, vaginal ultrasonography, and hormone concentrations indicated recovery of regular ovulatory cycles. Laparoscopy at 5 months confirmed the ultrasonographic data and showed the presence of a follicle at the site of reimplantation, clearly situated outside the ovaries, both of which appeared atrophic. From 5 to 9 months, the patient had menstrual bleeding and development of a follicle or corpus luteum with every cycle. 11 months after reimplantation, human chorionic gonadotrophin concentrations and vaginal echography confirmed a viable intrauterine pregnancy, which has resulted in a livebirth. INTERPRETATION: We have described a livebirth after orthotopic autotransplantation of cryopreserved ovarian tissue. Our findings suggest that cryopreservation of ovarian tissue should be offered to all young women diagnosed with cancer.

Adult↗
PubMed1990

Influence of the menstrual cycle on the absorption and elimination of D-xylose.

Thirteen healthy female volunteers with regular menstrual cycles (28 +/- 2 days) received 25 gm oral and 5 gm intravenous doses of D-xylose on 2 successive days during the follicular, ovulatory, and luteal phases of two consecutive menstrual cycles. The ovulation time was characterized by luteinizing hormone levels, body basal temperatures, and progesterone and estradiol serum levels. D-Xylose was assayed in plasma and urine with a phloroglucinol-based colorimetric method. The findings of this study indicated that menstrual cycle did not significantly affect D-xylose absorption. After oral administration, the total clearance was significantly increased in cycle 2 during the luteal phase (p = 0.004). After intravenous administration in both cycles, D-xylose total clearance was also significantly faster during the luteal phase (p = 0.038 and p = 0.041, respectively). After oral administration, the renal clearance tended to be higher during the luteal phase in both cycles studied. After intravenous administration, this parameter was increased during the luteal phase by 24% and 25% in cycle 1 and by 8% and 12% in cycle 2. These findings are consistent with those of others showing an increase in glomerular filtration rate (GFR) during the luteal phase of the menstrual cycle. The findings of this study seem to be explained by the hormonal changes occurring during the menstrual cycle. Further investigations are warranted with use of specific probes of renal processes (GFR, renal reabsorption and tubular secretion) to confirm our findings and to elucidate the underlying mechanisms.

Absorption↗
PubMed1993

Resting metabolic rate and diet-induced thermogenesis: a methodological reappraisal.

The variability in resting metabolic rate (RMR), diet-induced thermogenesis (DIT), and fuel utilization rates as well as the impact of several factors on RMR and DIT were assessed in several studies with a total of 103 males and females. The intraindividual CV of RMR and respiratory quotients was 5-6%. The intraindividual variability in DIT and fuel utilization rates was substantially higher. RMR did not change from morning to afternoon. The menstrual cycle phase did not affect RMR and DIT. DIT after mixed meals of 1.3-2.6 MJ could be assessed with good accuracy in 3 h. It is concluded that the low reproducibility of DIT implies that sample sizes of < 10 individuals with one measurement per subject and per treatment have power levels < 80% of assessing true, relatively large (50%) treatment effects or between-group differences in DIT.

Adult↗
PubMed1997

Increase in diet-induced thermogenesis at the start of refeeding in severely malnourished anorexia nervosa patients.

Many reports describe the difficulty for anorexia nervosa patients to gain weight during refeeding. To assess whether an increase in diet-induced thermogenesis (DIT) participates to this resistance, we studied DIT by indirect calorimetry in 11 severely malnourished anorexia nervosa patients [body mass index (BMI; in kg/m2) = 13] to accomplish two purposes: 1) to compare DIT in a strict semistarvation state with that obtained after 1 wk refeeding, when metabolism is shifted to a dynamic trend toward regaining weight, without significant change in body composition; 2) to study the effect on DIT of two energetic loads representing each one-third of the energy intake during semistarvation and refeeding, respectively: 1.25 and 2.92 MJ. To avoid bias, the two liquid loads were infused intragastrically in a random double-blind fashion. A significant increase in DIT during refeeding was observed for the two loads (204 +/- 23 kJ for the 1.25-MJ liquid meal and 482 +/- 78 kJ for the 2.92-MJ one, P < 0.02). The higher the load, the larger the increase with refeeding (P < 0.001). This increment in DIT exceeded the increase in active lean body mass and was poorly correlated with lean body mass. These results provide clear evidence of a strong cellular "waste" mechanism in anorexia nervosa patients during the early phase of refeeding, which enhances the adaptative resistance to overfeeding that we have already shown for resting energy expenditure.

Adolescent↗
PubMed1977

The diagnosis and therapy of luteal phase deficiency.

Between 1973 and 1975, 16 patients evaluated for infertility at Duke University Medical Center were diagnosed as having luteal phase deficiency. A majority had had prior infertility surveys, and the average duration of their infertility exceeded 2 years. The diagnosis was suspected after study of basal body temperature charts and menstrual patterns in more than 80% of the patients. This diagnosis was established by timed endometrial biopsy. The primary method of therapy was supplementation of the luteal phase with progesterone vaginal suppositories. The pregnancy rate after therapy was 50% and pregnancy occurred after a mean of five treatment cycles. The minimal follow-up of patients who failed to conceive was 8 months. To date, the majority of these pregnancies have been completed without complication and the remainder are progressing satisfactorily. Two additional patients developed luteal phase deficiency while taking clomiphene citrate and became pregnant with progesterone supplementation.

Body Temperature↗
PubMed2004

Mucus observations in the fertile window: a better predictor of conception than timing of intercourse.

BACKGROUND: Intercourse results in a pregnancy essentially only if it occurs during the 6-day fertile interval ending on the day of ovulation. The strong association between timing of intercourse within this interval and the probability of conception typically is attributed to limited sperm and egg life times. METHODS: A total of 782 women recruited from natural family planning centres in Europe contributed prospective data on 7288 menstrual cycles. Daily records of intercourse, basal body temperature and vaginal discharge of cervical mucus were collected. Probabilities of conception were estimated according to the timing of intercourse relative to ovulation and a 1-4 score of mucus quality. RESULTS: There was a strong increasing trend in the day-specific probabilities of pregnancy with increases in the mucus score. Adjusting for the mucus score, the day-specific probabilities had limited variability across the fertile interval. CONCLUSIONS: Changes in mucus quality across the fertile interval predict the observed pattern in the day-specific probabilities of conception. To maximize the likelihood of conception, intercourse should occur on days with optimal mucus quality, as observed in vaginal discharge, regardless of the exact timing relative to ovulation.

Adult↗
PubMedDate not supplied

Noninvasive measurement of brain temperature after stroke.

BACKGROUND AND PURPOSE: Brain temperature may be an important factor governing the extent of neuronal injury associated with stroke. The goal of this study was to develop a noninvasive method for measuring brain temperature, both to characterize the extent to which temperature changes after stroke and to test protocols designed to reduce brain temperature. We used an animal model to test the ability of 1H MR spectroscopy to measure temperature from infarcted brain tissue at 24 hours after insult. METHODS: Unilateral permanent focal ischemia in the middle cerebral artery territory was induced in adult dogs by intravascular delivery of microfibrillar collagen. MR imaging performed at 24 hours after insult was used to guide the implantation of temperature probes into the basal ganglia infarct and into the same anatomic location on the contralateral side. Serial non-water-suppressed 1H MR spectra were obtained from 1.3-cm3 voxels using an echo time of 136 and 272 ms, alternately, from the infarcted and contralateral non-infarcted tissue during a period when brain temperature was raised and lowered by whole-body heating and cooling. RESULTS: The chemical shift difference between the 1H MR spectroscopy signal of water and N-acetylaspartate or water and trimethylamines was plotted against brain temperature for two voxel locations. The slope and intercept of the plots obtained for infarcted and non-infarcted brain were not significantly different (P < .05, t test), and there was no difference between the slope and intercept of plots made from data collected with an echo time of 136 or 272 ms. CONCLUSION: The results of this study indicate that brain temperature can be measured from regions of brain containing infarcted tissue, at least up to 24 hours after ischemia. It should be possible to apply the 1H MR spectroscopy method used in the present study to measure brain temperature after stroke.

Animals↗
PubMed1984

An automatic electronic device (Rite Time) to detect the onset of the infertile period by basal body temperature measurements.

Two trials of an electronic thermometer (Rite Time), designed to record and interpret basal body temperature (BBT) patterns in normal ovulating women, are described. A total of 140 menstrual cycles from 34 women, who used the thermal or symptothermal methods of natural family planning, were studied. Rite Time gave a signal for the start of the infertile period in 117 cycles, of which 114 (97%) appeared to have occurred at appropriate times. Further studies using hormonal and ultrasound reference points for ovulation were carried out in 21 cycles. Rite Time generally produced BBT patterns of quality acceptable for interpretation of the periovulatory BBT shift. About one-half of the volunteers said that they would be willing to replace their conventional charting methods with Rite Time.

Body Temperature↗
PubMed1993

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.

Body Temperature↗
PubMed2002

Significant selective head cooling can be maintained long-term after global hypoxia ischemia in newborn piglets.

OBJECTIVE: Selective head cooling (SHC) combined with mild body cooling is currently being evaluated as a potentially therapeutic option in the management of neonatal hypoxic-ischemic encephalopathy. It is proposed that SHC enables local hypothermic neuroprotection while minimizing the deleterious side effects of systemic hypothermia. However, there is little evidence that it is possible to cool the brain more than the body for a prolonged period of time. The aim of this study was to examine whether the brain (T(deep brain)) could be cooled to below the rectal temperature (T(rectal)) in our piglet hypoxia ischemia (HI) model for a period of 24 hours, using a head-cooling cap. METHODS: Eight anesthetized piglets (median age: 15 hours) had subdural and intracerebral basal ganglia temperature probes inserted. After a 45-minute global HI insult (known to produce permanent brain damage), SHC using a cap perfused with cold water (5 degrees C-24 degrees C) combined with overhead body heating to maintain T(rectal) at 34 to 35 degrees C was performed for 24 hours. RESULTS: The piglets were cooled to a median T(rectal) of 35.0 degrees C (interquartile range [IQR]: 34.7-35.3) for 24 hours. During this time, the median T(deep brain) was 31.4 degrees C (IQR: 30 degrees C-32.2 degrees C), with a median T(rectal) to T(deep brain) gradient of 3.4 degrees C (IQR: 2.7 degrees C-4.8 degrees C). At the end of the cooling period, this gradient was still maintained at a median of 3.3 degrees C (IQR: 2.9 degrees C-3.7 degrees C). The ability to obtain the gradient was not influenced by the size of the piglet (1300-1840 g). Cap cooling lowered scalp temperature (T(scalp)) to a median of 24.9 degrees C (IQR: 22.2 degrees C-29.2 degrees C) and subdural temperature to a median of 28.1 degrees C (IQR: 25.8 degrees C-29.5 degrees C) but did not result in either skin injury or superficial brain hemorrhage. There was no clinically useful correlation between T(scalp) and T(deep brain) or between T(scalp) and T(subdural). CONCLUSIONS: This study using our piglet HI model shows that it is possible by means of a head-cooling cap to cool the brain more than the body for a 24-hour period while keeping the core temperature mildly hypothermic. However, we were unable to predict temperatures inside the brain using surface temperature probes on the head.

Animals↗