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[Salivary LH as an ovulation indicator: comparison between salivary LH, serum LH and ultrasonic findings].

A radioimmunological method of salivary LH determination has been developed as a new non invasive approach to hormonal ovulation detection. In this study salivary LH patterns have been compared to serum LH peak and daily sonographic assessment of follicle maturation in 15 spontaneous cycles of 9 women experienced in self-observation of their cycles (NFP). The day where the mature follicle was no longer visible sonographically was labelled day 0. Serum LH peaks occurred in 11 out of 15 cycles on day -1, two times on days -2 and 0 and preceded salivary LH peaks in 8 out of 15 cycles. The latter coincided in 7 cycles with day 0 in two cycles each with days -1 and +1 and in 4 cycles with day -2. Thus 13/15 serum- and 11/15 salivary-LH peaks occurred within +/- one day of the disappearance of the mature follicle. A time lag of up to six hours between the sampling of saliva and serum might explain the difference in the respective peak days, however, more studies into the kinetics of LH transport and its circadian rhythmicity seem necessary. Nevertheless, in principle also the salivary LH peak is considered a suitable indicator of ovulation.

Adult↗

[Salivary LH as an ovulation indicator: on the value of autopalpation of the cervix uteri for the detection of fertile and infertile days of the cycle].

The validity of autopalpation of the cervix as an indicator of fertility has been studied in 115 cycles of 13 nulliparous and 13 parous women, aged 22 to 35 years and experienced in self-observation methods (SOM) of family planning. For this purpose, the reported cyclic changes of the cervix uteri (hard, closed and low positioned; soft, open and higher positioned or intermediate stages) have been compared with the salivary LH-peak as indicator of ovulation, the BBT-readings and cervical mucus quality. The study has confirmed that in principle it is possible to collect sufficiently reliable self observation data for family planning purposes by autopalpation of the cervix. Parous women detect the first preovulatory changes of the cervix earlier and more frequently than nulliparous. Nevertheless it is not possible for either group to determine the beginning of the fertile days in this way. The beginning of the postovulatory infertile phase, however, can be detected: if, in accordance with rising BBT, the cervix has returned to a hard and closed appearance for 4 days, this symptom signals infertility with the same high degree of accuracy as the third measurement of elevated BBT (BBT3). Thus a "rule of thumb" can be established, linking the beginning of postovulatory infertility to either the fourth day of the hard and closed cervix or to the evening of the day of BBT3, "whatever comes first". In this way, the beginning of the infertile phase could be recognized one to three days earlier by referring to the cervix in about 20% of the cycles.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Inhibition of in vitro human chorionic gonadotropin-stimulated testosterone production in testis and of ovulation in the rat by charcoal-treated rat testicular extract.

Previously, we described the presence of a factor obtained from a 105,000 X g supernatant of rat testis that was found to inhibit human chorionic gonadotropin (hCG) binding to gonadal receptors. In the present study, similarly prepared testicular extract was tested for its effects on in vitro hCG-stimulated testosterone production by isolated testis interstitial cells and for its effect on spontaneous ovulation in the rat. Incubation of interstitial cells with charcoal-treated extract significantly inhibited the steroidogenic response to hCG in a dose-related manner. This inhibition was also apparent after heating the extract for 10 min at 100 degrees C. Preincubation of the cells with charcoal-treated extract resulted in an inhibitory effect that was not readily reversed by subsequent addition of hCG, revealing an element of irreversibility in the mechanism of inhibition. A single i.p. injection of testicular extract given between 1430-1630 h of proestrus inhibited spontaneous ovulation in the rat. This effect was also observed after heating the extract for 10 min at 100 degrees C; in contrast, no significant effect was obtained with the injection of a similar dose of liver extract. Administration of 5 IU hCG after pretreatment with the testicular extract did not reverse the inhibitory effect on ovulation, indicating that this effect was probably not exerted at the hypothalamus-pituitary level. It is concluded that the aqueous testicular extract contains a factor able to antagonize the physiological events mediated by luteinizing hormone (LH)/hCG, and that this factor is consistent with the presence of an LH/hCG-binding inhibitory activity in rat testis.

Animals↗

Induction of ovulation in seasonally anovular ewes by the introduction of rams: effects of progesterone and active immunization against androstenedione.

The effects of progesterone priming and active immunization against androstenedione on ovulation, oestrus ad premature luteal regression were observed in seasonally anovular Merino ewes which had been induced to ovulate by the introduction of rams. Ovulation was induced in 27 out of 36 ewes, and the response was not affected by either immunization or progesterone priming. The ovulation rate (mean number of ovulations per ewe ovulating) was higher in ewes immune to androstenedione, but there was no significant effect of this treatment on oestrus or luteal maintenance. Priming with progesterone prior to the introduction of rams prevented premature regression of the corpora lutea but had no effect on the other measures of reproductive function. If active immunization were to be applied on a commercial scale, it would not interfere with the practice of mating ewes during the anoestrous season. The increase in ovulation rate in these ewes, with no increase in the proportion of ewes ovulating, indicates that the mechanism for the control of ovulation is separate from that controlling ovulation rate. The mechanism by which progesterone pretreatment prevents premature luteal regression awaits further investigation.

Androstenedione↗

Elevated tissue type plasminogen activator in human granulosa cells correlates with fertilizing capacity.

An increased production of plasminogen activators, able to convert plasminogen into plasmin, has been found in experiments in vivo on rat ovarian granulosa cells at the time of ovulation, indicating an involvement in follicular rupture. The granulosa cells of 49 follicles from 20 patients undergoing in-vitro fertilization were obtained by laparoscopy and tested for the content of urokinase-type plasminogen activator (u-PA), tissue-type plasminogen activator (t-PA) and inhibitor of plasminogen activator (PAI). In the respective follicular fluids the concentrations of oestradiol (E2), progesterone (P) and testosterone (T) were determined and the levels of these enzymes and of the follicular steroid content were related to the fertilizing behaviour of the respective oocytes. Follicles containing oocytes which could be fertilized, revealed significantly higher follicular fluid E2 and P levels and significantly lower T levels than follicles with unfertilized oocytes. The respective granulosa cells of fertilized oocytes exhibited higher levels of t-PA compared to their unfertilized counterparts, whereas no significant difference occurred in the levels of u-PA and PAI. These data suggest that successful fertilization of human oocytes is associated with a high content of t-PA in granulosa cells and high E2 and P levels in the follicular fluid.

Adult↗

Mating-induced luteinizing hormone surge and ovulation in the female camel (Camelus dromedarius).

Blood samples were collected after mating from four female one-humped camels every 10 min for 9-12 h. Luteinizing hormone (LH) was quantified in plasma by radioimmunoassay using antibovine LH. Of the seven observed matings, five were followed by a release of LH, and three by an ovulation (indicated by a subsequent secretion of progesterone). LH levels at the time of mating ranged from 0.7 to 3 ng/ml. When an LH response occurred, the levels increased 1 h after mating and reached a maximum in 2-3 h (ranging from 2.9 to 19.1 ng/ml). A decrease in LH was observed starting 6 h after mating and lasting for 6 h. These results are in agreement with a coitus-induced mechanism of ovulation in the one-humped camel (Camelus dromedarius). They confirm and extend the observations reported in the bactrian camel (Camelus bactrianus).

Animals↗

Assessment of ovarian function in perimenopausal women after stopping oral contraceptives.

Ovarian function was assessed by measuring plasma gonadotrophins, urinary oestrogen and urinary pregnanediol levels, every week for four weeks, in 34 women, aged 45 to 57 years, after withdrawal of oral contraceptive therapy. A rise in urinary pregnanediol excretion occurred in 14 patients suggesting that ovulation had occurred and that these patients were "premenopausal". Elevated serum gonadotrophin values and persistently low urinary oestrogen and pregnanediol excretion occurred in 13 patients suggesting ovarian failure or a "postmenopausal" state. However, one apparently "postmenopausal" patient later showed hormonal evidence of ovulation, indicating fluctuation in ovarian function. There were 7 patients with "indeterminate" hormone profiles whose ovarian function was difficult to assess. All patients excreting more than 45 nmol of oestrogen a day had a spontaneous period within 45 days of stopping hormone therapy.

Adult↗

Outcome of pregnancy in underweight women after spontaneous and induced ovulation.

Low maternal weight before pregnancy and poor weight gain during pregnancy are known to result in an increased prevalence of low birthweight infants. Low body weight is also an important cause of amenorrhoea. The hypothesis that amenorrhoeic underweight women who become pregnant after induction of ovulation are more at risk of delivering low birthweight infants than underweight women who ovulate spontaneously was investigated. Forty one pregnant women in whom ovulation had been induced and 1212 in whom ovulation was spontaneous were studied. Women ovulating spontaneously whose weight was normal and who showed good weight gain during pregnancy (greater than 450 g a week) had the lowest incidence (6%) of babies who were small for gestational age. Underweight women (body mass index less than 19.1) who ovulated spontaneously had a threefold increased risk of delivering babies who were small for gestational age (18%). Overall, the women in whom ovulation had been induced had an even higher risk of babies who were small for dates (25%), and the risk was greatest (54%) in those who were underweight. The outcome of pregnancy is related to weight before conception, which in many cases reflects nutritional state; lack of spontaneous ovulation indicates an increased risk of producing a small for dates infant. The most suitable treatment for infertility secondary to weight related amenorrhoea is therefore dietary rather than induction of ovulation.

Body Weight↗

Sonographic evaluation of normal and induced ovulation.

The adult premenopausal ovary exists in a dynamic state of flux, with ovarian position, size, activity, and structure constantly undergoing changes. Pelvic sonograms must be interpreted with knowledge of the stage of the menstrual cycle and the expected normal range of sonographic findings, because features that are normal in one phase may be abnormal in another. Only against this background knowledge can the challenging task of interpretation of pelvic sonograms be successfully performed. US also plays an increasingly important role in monitoring ovulation induction and alternative methods of fertilization and has improved pregnancy rates by distinguishing between the presence of one or more mature follicles as opposed to a cohort of immature follicles, suggesting the possibility of multiple ovulation with the risks of hyperstimulation or poor pregnancy outcome from multiple gestation, indicating optimum timing of human chorionic gonadotropin administration, allowing detection and confirmation of normal follicular rupture and ovulation, indicating optimum timing of oocyte retrieval in programs of in vitro fertilization with embryo transfer (IVF-ET) or insemination programs, and assessing pathologic pelvic conditions and ovarian accessibility in IVF-ET programs. Oocyte retrieval and embryo transfer are also being performed under US guidance.

Anovulation↗

Influence of alpha-melanotropin on LH release in the rat.

The effects of MSH on spontaneous and induced ovulation as well as on serum LH levels were studied. Rats which received progesterone on D1 and D3 were injected i.p. with 30 microgram of alpha-MSH or saline solution and examined for ovulation on the following day. The injection of alpha-MSH induced ovulation in 90% of the animals; saline solution, on the contrary, induced an ovulatory response only in 10% of the cases. Rats injected with beta-MSH yielded similar results to those injected with saline solution, indicating a possible specific alhpa-MSH action. The replacement of the second progesterone injection by alpha-MSH failed to increase to ovulation indicating that alpha-MSH synergizes or alters progesterone action. It would seem that alpha-MSH stimulates ovulation-potentiating progesterone effects on the CNS. LH effectively induced ovulation in rats where spontaneous ovulation was blocked by an injection of progesterone on D1. The i.p. injection of 30 microgram alpha-MSH lowered the amount of LH necessary to induce ovulation. Rats which received alpha-MSH and LRH showed a marked increase in serum LH levels compared with rats where alpha-MSH had been replaced by saline solution. Collectively the information provided in this paper is consistent with the view that the release of MSH observed in the morning of PE would signal the discharge of LH from the pituitary gland occurring in the afternoon of PE.

Animals↗

Follicular growth and maturation in the domestic hen (Gallus domesticus).

The rate of follicular development in hens was assessed by measuring the increase in the diameter of follicles during 120 h before ovulation and the mass of follicles during 48 h before ovulation. The rate of follicular maturation was estimated by the ovulatory response of follicles to an injection of GnRH and the ability of follicles to produce progesterone in response to an injection of LH. Follicular diameter and follicular mass increased until ovulation, indicating that the follicle continues to sequester yolk material until ovulation occurs. The ovulatory response to GnRH and the production of progesterone in response to LH were negligible until 10 h after ovulation and then both aspects of follicular competence began to be functional. It was concluded that the size of the hen's ovum is not a primary factor regulating ovulability; rather, the acquisition of the ability to ovulate spontaneously is associated with the ability to produce progesterone in response to an LH stimulus. The ability to ovulate in response to GnRH was acquired more quickly in hens laying long sequences than in hens laying short sequences, indicating that the ovulatory response of the follicle can be used to assess the reproductive potential of laying hens.

Animals↗

Pre-ovulatory arrest and peri-ovulatory redistribution of competent spermatozoa in the isthmus of the pig oviduct.

Using the surgical approach of post-coital ligation and transection of the distal oviduct at different times relative to ovulation, together with subsequent recovery of the eggs, gilts mated at the onset of oestrus were studied for progression of viable spermatozoa within the isthmus. Results are derived from 76 animals and examination of 1047 eggs. Transection of the isthmus 1.5-2.0 cm proximal to the utero-tubal junction at intervals from 3 to 36 h after mating prevented fertilization in 269 of 270 eggs, whereas 98% of 223 eggs were fertilized in the control oviducts. Transection at 38 h (pre-ovulatory), 40 h (peri-ovulatory) and 42-44 h (post-ovulatory) after mating yielded, respectively, 5%, 40% and 100% fertilization. The mean number of spermatozoa associated with the zona pellucida increased in a parallel manner. These results, and those obtained with ligatures placed closer to the site of fertilization just after ovulation, indicate a pre-ovulatory arrest of viable spermatozoa in the caudal region of the isthmus for 36 h or more followed by an active ad-ovarian redistribution.

Animals↗

A comparative study on involvement of tPA activity in ovulation induced by hCG and GnRH agonist in hypophysectomized rats.

A GnRH agonist (5-50 micrograms) is capable of inducing ovulation in PMSG-primed hypophysectomized immature rats, as is the case in hCG-induced ovulation, but 2-4 h earlier than hCG. GnRH-induced ovulation is effectively blocked by the concomitant administration of the GnRH-antagonist which failed to interfere with hCG-induced ovulation, indicating that GnRH and its agonists do not share a receptor with LH/hCG. Like hCG, GnRH is also capable of inducing tissue type (tPA), but not urokinase type (uPA) PA. The plasminogen activator activity in ovarian homogenates and the granulosa and theca-interstitial cells increase in a time-dependent manner, reaching maximum levels just prior to ovulation. Similar to hCG, GnRH also increases tPA activity in cumulus-oocyte complexes in a time-dependent fashion.

Animals↗

Precoital single doses of delta9-tetrahydrocannabinol block ovulation in the rabbit.

delta9-Tetrahydrocannabinol (delta9-THC) inhibits pituitary gonadotropin secretion in castrated rhesus monkeys. Also, delta9-THC blocks the ovulatory reflux in rabbits. We report now the dose-response relationship of precoital single doses of delta9-THC on luteinizing hormone (LH) release and ovulation in the rabbit. Forty-five female rabbits in estrous were divided into nine groups of five animals. Groups 1 to 5 received a single intramuscular dose of delta9-THC (5,2.5, 1.25, 0.612, and 0.306 mg/kg, respectively) 2 hours before mating; animals of group 6 received vehicle only. In animals of groups 7 and 8 ovulation was induced with 100 IU of human chorionic gonadotropic (hCG), given intravenously 2 hours after the administration of delta9-THC (5 mg/kg) or vehicle. Rabbit luteinizing hormone (rLH) was measured in plasma 90 to 120 minutes after coitus or hCG administration. After the injection of 5 mg of delta9-THC, luteinizing hormone-releasing factor (LH-RF) (20 microgram intravenously) was administered to the animals of group 9. All animals of groups 6, 7, and 8 ovulated. A dose-response curve was observed in the animals treated with delta9-THC and natural mating. Whereas none of the animals treated with 5 or 2.5 mg/kg ovulated, one of the group treated with 1.25 mg/kg, two of the group treated with 0.612 mg/kg, and all treated with 0.312 mg/kg ovulated. Ovulations correlated with postcoital levels of rLH. All animals of group 9 ovulated, indicating that the site of action of delta9-THC is suprapituitary, probably hypothalamic.

Animals↗

The recovery of ovarian function during breast-feeding.

The pattern of breast-feeding was daily recorded and the serum concentrations of prolactin (PRL), FSH, LH, estradiol (E2) and progesterone (prog) were measured at weekly intervals in 26 breast-feeding mothers from the time of delivery and up to the resumption of regular ovulation or to the end of the first postpartum year. Twelve postpartum non-breast-feeding women were similarly studied as controls. An algorithm was used to characterize ovulatory events into three types: the first, with evidence highly suggestive of normal ovulation (EHSO), the second, with evidence of probable ovulation (EPO) and the third with evidence indicating questionable ovulation or deficient corpus luteum function (QO/DCT). Pregnancy preceded the first menstruation in one woman in each of the breast-feeding and control groups. Of the 19 breast-feeding women who started to menstruate during the first postpartum year, five had EHSO, one had EPO, 5 had EQO/DCL and 7 had anovulatory (AO) menstruation. The corresponding figures in the 11 controls were 6, 2, 3 and 0. Pregnancy occurred before a second menstruation in one woman in both the study group and the controls. In 18 breast-feeding women observed, the second menstruation was preceded by EHSO in 7, by EPO in 3, by EQO/DCL in one and AO in 7. In 10 controls the corresponding figures were 7, 3, 0 and 0. Out of a total of 79 menstruations observed during breast-feeding the incidence of AO was 30% and of QO/DCL was 15%. In actively breast-feeding mothers, hyperprolactinemia persisted for more than 1 yr. However, menstruation and ovulation occasionally occurred before the drop of PRL to concentrations seen during the normal menstrual cycle. In the majority of women, low E2 levels were present during lactational amenorrhea, but with occasional spikes in some. A few women maintained somewhat high values of E2 for several weeks before the resumption of menstruation. The implications of these hormonal findings to the attempts to improve on the contraceptive effect of breast-feeding are discussed.

Adult↗

Interobserver variation in estimation of day of conception intercourse using selected natural family planning charts.

In order to study outcome of pregnancy related to timing of conception it is necessary to have both markers of ovulation and records of intercourse. Natural family planning (NFP) charts where the woman records basal body temperature (BBT) and mucus signs are ideal for this purpose. Much work has been done relating timing of BBT and mucus signs to ovulation, but very little work has been done to examine interobserver agreement on the interpretation of these signs. Four NFP experts examined 28 NFP pregnancy charts to determine the BBT rise, the mucus peak, and two most likely days of conception intercourse. The charts were selected because they provided difficulties in interpretation. The reviewers were able to agree on the most probable day of conception intercourse in 96.4% of cases, on the mucus peak in 74.1% of cases, and on the interval between the most probable conception intercourse and mucus peak in 70.4% of cases. There was poor agreement on the first day of the BBT rise (38.5%). The authors conclude that in selected difficult NFP charts, the mucus peak is a more valid indirect measure of ovulation both because it is subject to less interobserver variation and because it more closely approximates the timing of ovulation.

Body Temperature↗