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Detection Of Ovulation Essay

2036 words - 9 pages

Preventive Powers of Ovulation and Progesterone
Detection of Ovulation
by Dr. Jerilynn C. Prior, Scientific Director, Centre for Menstrual Cycle and Ovulation Research. I believe that ovulation with a normal luteal phase length – and normal amounts of progesterone to counterbalance and complement estrogen – is of key importance for women’s bone, breast and heart health (see Ovulatory Disturbances - They Do Matter [PDF]). In the last issue we discussed how you, personally, can tell that you are ovulating using the Molimina Question, recording and analyzing your basal temperature using quantitative methods (called QBT), and possibly using the over-the counter fertility test detecting the ...view middle of the document...

Detecting ovulation using ovarian ultrasound When sound waves are passed through the lower abdomen and a full bladder to observe the ovary (called abdominal ultrasound) or through the vagina (vaginal

ultrasound) the ovaries shows up as small elliptical masses on each side of the pelvis (1). To determine if ovulation is occurring, usually the test is scheduled every day from about cycle day 10 (meaning the 10th day after the first day of flow) until ovulation is detected. What tells about ovulation is that one, of possibly several, small round fluid-filled bodies (called cysts), will gradually grow until it is about the size of a thumbnail (18 mm) (2). This is then called a “dominant follicle” because it is the one that is likely to release an egg. After seeing the growing dominant follicle, one day it will have vanished. This sudden loss of the dominant follicle cyst is presumed evidence that it ruptured thus releasing the egg into the pelvis. The ultrasonographer would declare that the woman ovulated. This method for ovulation detection is expensive (more than $100 for each scan), takes specialized equipment, requires a woman to travel to a medical centre, and is uncomfortable (especially holding a sufficiently full bladder), or the vaginal exam can be embarrassing as well as time consuming. Finally, there are potentially other reasons for “losing” sight of the dominant follicle besides ovulation. Detecting ovulation using tissue from the uterine lining This test (called an endometrial biopsy) involves going to a doctor’s office or centre about three weeks after the last period, having a pelvic exam followed by the insertion of a small probe through the vagina and into the uterus. This probe is equipped to scrape or bite off a small bit of the lining of the uterus. The cells are then prepared, stained and viewed under a microscope. If the uterine lining is proliferative and only under the influence of estrogen it is thick but without small glands. If ovulation has occurred, and the lining is changing, as it should, under the influence of progesterone, the lining has many glands. The endometrium has a fairly typical pattern each successive day of the cycle. The pathologist who is specially trained to read these slides, can compare this standard with the biopsy taken from a given woman. The biopsy is said to be showing proliferation (meaning the effects of estrogen alone), proliferation with atypical changes (a risk factor for endometrial cancer), “secretory” which means evidence for progesterone action and that ovulation has taken place, and finally, whether or not the biopsy is “in phase” or appropriate for the day of the cycle (3). Although this endometrial biopsy is more directly observing the actions of progesterone on the uterine lining, there is a lot of normal variability. It takes several days after ovulation and the rise of progesterone before clear changes occur and ovulation can be diagnosed (just as it takes a few days for the...

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