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Methods of monitoring ovarian function and predicting ovulation: summary of a meeting

Methods of monitoring ovarian function and predicting ovulation: summary of a meeting

Research Frontiers in Fertility Regulation 3(5): 1-16

This report summarizes the proceedings of an international meeting sponsored by Family Health International on methods of monitoring ovarian function and predicting ovulation. The imprecision of current indirect methods for predicting the timing of ovulation, as well as pressures from natural family planning, artificial insemination, and in vitro fertilization programs, have provided impetus for advances in this field. Among the purposes of the meeting were to identify the limitations and potential of available methods of monitoring ovarian function and predicting ovulation, define those approaches requiring further development, and stimulate the collaboration necessary for production of a new generation of techniques. This report highlights the current status of indicators that have been used to predict the limits of the fertile period and the time of ovulation. Natural family planning indices reviewed include cervical mucus, basal body temperature (BBT), algorithms for prospectively interpreting BBT, the symptothermal method (STM), and cervical changes. Other indices discussed include ultrasound monitoring, gonadotropin measurement, steroid metabolites, enzymes and ions, pregnancy, and prolactin in lactating women. Combinations of 2 or more methods can delineate the fertile period in over 95% of cycles. If the exact timing of ovulation needs to be predicted, cervical mucus or STM should be augmented by indices such as increase in follicle size, the rise or peak in luteinizing hormone levels, attainment of peak estradiol, or the initial rise in progesterone. Technological improvements in the endpoints used in immunoassays could lead to development of self-tests and reduce costs. Research in 3 areas might improve the effectiveness of physiologic and biochemical indicators: 1) the fertile spans of gametes within the female tract, 2) spontaneous early embryonic loss; and 3) lactational amenorrhea. Close collaboration between laboratory scientists and directors of family planning programs would facilitate this research.

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Accession: 046676306

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PMID: 12179636

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