[Detection of ovulation by changes in the color in the cervical mucus].
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A specific, sensitive, and rapid radioreceptor assay (RRA), employing membranes from bovine testes as receptor and [125I]hLH as radioligand, has been developed for measurement of human LH in serum. This RRA was used to determine the time of ovulation in seven women. For comparison, four hourly values around midcycle were measured by RIA. The sensitivity of the RRA was 0.78 ng/ml serum and could be increased by prolonged incubation. The coefficient of within and between assay variation at the 50% inhibition level was 7% and 13%, respectively. The mean index of discrimination (RRA/RIA) was 1.02, expressed by the slope of the regression curve. The coefficient of correlation was 0.97. In all women, the LH surge was detected by RRA, and the subsequent ovulation was verified within 30 h by endoscopic examination of the ovaries, as well as serum progesterone concentrations of more than 5 ng/ml on the fifth day after ovulation. As shown, prospective ovulation timing can be done by this simple and accurate method. The RRA can be useful in infertility therapy such as artificial insemination.
Cervical mucus viscosity (CMV) and fern test (FT), leukocyte alkaline phosphatase (LAP) activity, basal body temperature (BBT) and serum luteinizing hormone (LH) levels were determined during 31 normal menstrual cycles of 29 volunteers. The day of the serum LH surge was taken as a reference point in evaluating the reliability and sensitivity in predicting ovulation of the other tests studied. Serum LH surge was accompanied by a sudden decrease in CMV, an increase in LAP activity, a gradual increase in FT and biphasic changes of BBT. In about 95% of cycles studied, the lowest values of CMV and peak values of LAP activity appeared on the day of the serum LH surge or one day before or one day after. The lowest point of the BBT coincided with the LH surge in only 26% of cycles. In 53% of cycles, the span was greater than one day before or after the LH peak. The FT corresponded to the LH surge in only 33% of the cycles, while in an additional 33% the preovulatory FT response occurred more than one day before or after the LH surge. The results indicate that CMV and LAP tests are rapid, simple and reliable for monitoring follicular maturation and the timing of ovulation when carried out daily, and may be of value in monitoring treatment during the induction of ovulation.
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.
The serum levels of luteinizing hormone (LH), estradiol-17beta, and progesterone were determined simultaneously with the concentrations of immunoglobulin (Ig) G, IgA, C'3, alpha1-antitrypsin, inter-alpha-trypsin inhibitor, alpha1x-antichymotrypsin, albumin, and lysozyme in cervical mucus during nine ovulatory cycles. Spinnbarkeit and ferning were also assessed, and the basal body temperature was measured and recorded during these cycles. The profiles were synchronized according to the LH peak. The midcycle period, characterized by the rapid increase and decline of estrogen and the beginning rise of progesterone, shows a prounced minimum of immunoglobulins, C'3, proteinase inhibitors, albumin, and lysozyme in cervical mucus, which is known to be most receptive to sperm penetration at this time. Although the variation of cervical mucus values is considerable during the early proliferative and the luteal phases, the midcycle values appear to be constantly low, showing slight differences among the profiles of the different parameters. The statistical evaluation and the assessment of the significance of parameters for ovulation detection and the assessment of the fertile period as well as the correlation of these parameters with basal body temperature will be the subject of the second communication of this series.
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Laparoscopy was utilized as the final step in the infertility investigation of 155 indigent patients. Unnecessary laparotomy was avoided in 72 (46 per cent) of these patients. Depending upon the endoscopic findings, the presence of additional infertility factor(s) either positively or negatively affected prognosis. With the same anesthetic, 83 (54 per cent) of the 155 patients underwent conservative infertility operations. Unless even greater selectivity can be achieved by prior diagnostic laparoscopy, the postoperative term pregnancy rate (11 per cent) does not justify infertility operations in a population prone to pelvic inflammatory disease, particularly in those individuals with other infertility factors.
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Twenty-seven wives participating in a study of sexual activity patterns had identifiable shifts in basal body temperature and midcycle surges of serum luteinizing hormone (LH). When sexual activity data were examined using the LH surge as a centering point, it was observed that the day before the LH surge had only an average probability of coitus and organism. These findings suggest that neither coitus nor orgasm often triggers ovulation in humans. This cannot be taken as evidence that coitus-induced ovulation never occurs.
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A trial was carried out in 10 healthy women to study the effects of withdrawal of treatment with 0.5 mg lynestrenol per day, for 3 successive days during the pre-ovulatory phase, on the physiological properties of the cervical mucus, vaginal cytology and pituitary and ovarian functions. In most cases, the amount, Spinnbarkeit and ferning of the cervical mucus and sperm penetration remained the same as that before interruption of treatment. In 2 women, the ferning altered to 'good' for 2 to 3 days as the amount of mucus increased slightly. Spinnbarkeit increased at the same time and sperm penetration was good. The changes in LH and FSH excretion suggested that ovulation possibly took place in 1 of the women studied. A mid-cycle oestrogen peak was seen in 2 women. No side-effects were reported during the study apart from irregular intermenstrual bleeding in 1 woman.
Methods based upon the principles of radioimmunoassay have been developed and evaluated for the measurement of oestrone-3-glucuronide, LH and pregnanediol-3alpha-glucuronide in samples of unextracted urine. The procedures have been applied to daily urine (early morning fraction and combined 24 hour collections) from 6 women throughout one complete menstrual cycle and to serial samples from an additional 14 women who only collected early morning specimens. The results showed that there were characteristic, well-defined changes in the concentration of all 3 metabolites in both samples of urine and from all subjects. In addition, there was a reasonable correlation between the concentration of all 3 compounds in samples of early morning urine and the corresponding rates of excretion per 24 hours. These findings suggest that the procedures may be of value for monitoring ovarian function over long periods of time, without the problems of stress and inconvenience to the patient. Furthermore, the ratio of values for oestrone-3-glucuronide to pregnanediol-3alpha-glucuronide may be used to indicate the start and finish of the fertile period.
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The concentration of sialic acid was determined in the reproductive organs, pituitary gland and urine of male and female langur monkeys. In the male, sialic acid concentration was lowest in the testes and highest in the epididymides. Both caput and cauda epididymides contained almost the same concentration. Castration and subsequent androgen administration did not modify the concentration of sialic acid by comparison with intact animals, suggesting that sialic acid is not androgen-dependent in the langur. There was no significant difference in sialic acid concentration in the uterus during the proliferative and luteal phases of the menstrual cycle. After ovariectomy, there was a decrease in the concentration of sialic acid in the uterus, cervix and vagina while oestrogen or oestrogen plus progesterone administration increased its concentration significantly, but not to the control level. However, the difference in concentration between oestrogen-treated and oestrogen plus progesterone-treated monkeys was not significant. There was a peak of sialic acid excretion in the urine on day 8 of the normal 22-day menstrual cycle, i.e. a day before the probable day of ovulation. In pregnant monkeys siliac acid excretion increased significantly 2 days before delivery compared with the values recorded 7 to 3 days before parturition. The part played by sialic acid during the menstrual cycle and pregnancy in the female is not clear.
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Preselective sex determination in ten consecutive pregnancies has been achieved by means of strict control over timing and technique of coitus which was combined with acidic or alkaline douching. Eight female and two male babies were born.
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The Authors describe the laparoscopic aspects of spontaneous human ovulation and correlate it with the evaluation of basal body temperature, the total urinary oestrogens, pregnanediol and urinary LH and some hematic values of 17-beta-estradiol, 17-alpha-Hydroxyprogesterone and rogesterone. They find that the rise in temperature and the oestrogenuria peak precede ovulation by some hours in the great ovulation by sompe hours in the great majority of cases. They analyze the validity of the other parameters studied, and show a relatively constant behavior, with regard to ovulation, in the mean evaluation of several cases. In the individual analysis, on the contrary, this relation is difficult to find and less significant. The Authors stress the importance of comparing the physico-chemical evaluations with the biological phenomenon of ovulation directly ascertained by means of laparoscopy.