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Optimal features of basal body temperature recordings associated with conceptional cycles.

Oral basal body temperature (BBT) recordings of 46 women that conceived by donor insemination and who had midcycle monitoring of luteinising hormone (LH) were analysed to establish features associated with an optimal cycle. All cycles exhibited a biphasic temperature shift associated with the follicular (mean + SD, 36.5 degrees C +/- 0.22) and luteal phases (36.8 degrees C +/- 0.19). Whilst a mean body temperature rise occurred on Day +1 when all cycles were analysed, individual patterns were seen at ovulation including no change or a decrease in BBT between Day 0 and Day +1. The BBT of the postovulatory phase was stable and only 4.5% of the 644 observations made showed a change of more than 0.2 degrees C from day to day. It was concluded that the BBT charting has limitations when used to recognize the day of ovulation, and that some variable patterns of the early luteal phase are consistent with conception. Finally, optimal luteal phases demonstrated remarkable stability.

Body Temperature↗

Contraception.

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Abortion, Induced↗

Cervical mucus immunoglobulins as an indicator of ovulation.

A practical and accurate method of determining ovulation using cervical mucus is described. Ovulatory cycles from 32 healthy women were assessed using hormonal and nonhormonal methods. Cervical mucus extractable immunoglobulins were assayed for the complete cycles of nine women and randomly collected from 23 additional women with normal cycles. All normal ovulatory women showed a minimum concentration present at midcycle when optimum conditions for fertilization existed. Using newer laser nephelometry techniques, the content of extractable immunoglobulin G and immunoglobulin A per sample weight confirmed the cyclic nature of the concentration of immunoglobulin in cervical mucus, and correlated well with previously defined biophysical properties of cervical mucus. Nephelometry proved to be rapid, accurate, and an inexpensive technique for determining ovulation and has potential for clinical use.

Adult↗

A study of the detection of sperm antibody in cervical mucus with a modified immunobead method.

OBJECTIVE: To develop a new immunobead binding test (IBT) procedure that will detect sperm antibody in cervical mucus (CM), especially in very small samples of mucus. DESIGN: After the interaction of donor sperm with bromelin-dissolved CM, the motile sperm cells were separated from other cells and debris and then tested with a standard immunobead method. SETTING: The CM and serum samples were obtained from a sequence of referred patients who were sent to this testing laboratory. PATIENTS: There were 60 women who provided 64 samples of CM and 41 samples of blood serum. They were partners in infertile couples. INTERVENTIONS: None. MAIN OUTCOME MEASURE: A useful distinction was made between positive and negative results for the mucus samples by this CM-IBT procedure. The usable samples of mucus could be as little as 0.05 g (wet weight). RESULTS: From the 60 women, seven mucus samples were positive; in the repeated testing, the same results were obtained with five of the six positive samples and seven of seven negative samples. CONCLUSION: This method (CM-IBT) can be clinically useful for detecting sperm antibody in CM, especially because it is effective for tiny samples. In this method, the motile sperm cells are better separated from the debris after the incubation step. When the IBT was applied to the serum samples from the same women, there was no correlation between serum-IBT and CM-IBT, showing that both materials must be tested.

Antibodies↗

A diaphragm tampon applied to an ovulation method in a birth control system.

Gynaeseal is a re-usable diaphragm tampon made from latex which forms a unique cervico-vaginal seal and isolates menstrual loss. In a prospective study involving 80 women, Gynaeseal was offered in combination with the Billings Ovulation Method in an advised birth control system. This system included: use of the diaphragm tampon during the menstruation-fertile phase interphase; periodic abstinence during the overtly fertile phase of the cycle; and if extreme reliability was required, for a further 2 days after the Billings method 'rules' allow resumption of intercourse. The diaphragm tampon successfully complemented the Billings Ovulation Method with 44 women (60.4%) assessing the GOM System as being as good, or better than, currently available reversible methods. It functioned effectively as a tampon with 50% (31 women) stating that they used the product as a contraceptive. One woman claimed an unplanned pregnancy. No significant medical complications were recorded. The product has major advantages as a tampon: it is easily and accurately inserted because of the efficient applicator; it isolated menstrual loss within a collection chamber; it protects the cervix; and it facilitates sexual activity. Based on a minimum effective diameter (62mm), the diaphragm tampon does not interfere with the normal physiology of the vagina. There appeared to be no significant distortion of normal adult pelvic anatomy, and properly placed, no sensation of the diaphragm tampon's presence. Regarding insertion of the diaphragm tampon using the spiral-curved applicator: 31 women (42.5%) had little or no difficulty; 29 (39.7%) moderate difficulty; 13 (17.8%) experienced serious difficulty; and 7 (8.7%) were unable to use the product.

Adolescent↗

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↗

Ovulation devices update.

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Clinical Laboratory Techniques↗

Cumulative pregnancy rates in patients with apparently normal fertility and fertility-focused intercourse.

Fifty consecutive clients achieved pregnancy using a standardization modification of the Billings ovulation method (the Creighton Model Natural Family Planning System). Of 50 clients followed, 38 (76%) achieved pregnancy in the first cycle of fertility-focused intercourse, 45 of 50 (90%) achieved pregnancy by the third cycle and 49 of 50 achieved pregnancy by the sixth cycle (98%).

Adult↗

The diagnostic and therapeutic potential of the postcoital test.

An analysis was made of postcoital tests carried out on 423 couples attending the Rotunda and St. James Hospitals in Dublin. Initially 66.6% of tests were abnormal, but 21.3% of these were invalid because of the presence of seminal or cervical abnormalities, leaving 57.7% of couples with initially valid negative tests. Retesting showed 30.3% of couples to have persistently negative tests, 24.5% of whom achieved pregnancy. Three per cent of abnormalities were immunologic in origin. The most common cause why a subsequently positive test was initially negative was failure to observe correct clinical procedures, but unadmitted psychosexual problems were present in 17.6% of cases. Of the best postcoital tests, 78.5% correlated well with semen analyses and 90.9% with basal body temperature charts. In total, 6.2% of all pregnancies achieved in the clinics followed postcoital testing.

Cervix Mucus↗

Natural family planning.

Natural family planning includes the calendar (rhythm), basal body temperature, ovulation (mucus), and sympto-thermal methods. Reliability of such methods often is underestimated, but effectiveness of various methods has been reported. Correct understanding and use of proper techniques, primarily abstinence during fertile periods, is imperative for effectiveness. New methods being studied may heighten awareness of fertile times and shorten required periods of abstinence or use of back-up methods.

Adolescent↗

Temporal relationships between indices of the fertile period.

The intra- and interwoman variation in nine physiologic or biochemical indices of the fertile period has been studied over 58 menstrual cycles from 13 experienced users of the symptothermal method of family planning by periodic abstinence. The time and duration of a possible fertile period have been determined by five methods (symptothermal, cervical mucus, basal body temperature plus calendar calculation, defined changes in the concentration of estrone-3-glucuronide and the ratio of estrone-3-glucuronide to pregnanediol-3 alpha-glucuronide as determined by immunochemical tests on daily samples of early morning urine). The values were compared with a period of probable fertility (day of urinary luteotropin [LH] peak -3 to day of LH peak +2). The duration of the possible fertile period by each method (mean +/- standard deviation) was 13.4 (2.9), 11.9 (2.9), 11.8 (3.3), 9.3 (2.2), and 10.9 (2.3) days, respectively, while the percentage of the probable fertile periods covered entirely by each approach was 98%, 91%, 90%, 83%, and 84%, respectively. The results warrant the initiation of clinical trials to ascertain the practical value of the individual or combined tests for family planning and the management of infertility.

Adult↗