Basal Body Temperature Charts Research Articles

Smartphone Technology Paired with a Vaginal Conforming Cap to Enhance the Fertility Awareness Method for Modern Women

Background: Fertility Awareness Method (FAM) cost-effective and the safest contraceptive method yet it is rarely used. Objectives: A) Familiarize women, and clinicians with the enhancement to the fertility awareness method. B) Persuade investigators to validate this pilot study by providing additional research. C) Allow women to pinpoint the precise day of ovulation. Materials and Methods: We recruited 40 healthy women with regular periods to participate in this pilot research for 3 months. 20 used the traditional FAM with basal body temperature and fertile cervical mucus. The other 20 women used the conforming vaginal cap to collect their fertile cervical mucus (Spinnbarkeit). Starting at day 9 they collected samples directly from the cervix until they detected fertile mucus. We also instructed them to record their findings and any side effects. Results: Women using the vaginal conforming cap identified preovulatory fertile cervical secretions in 95% of cases. They also verified ovulation with a positive urinary L.H. (Luteinizing Hormone) surge. Basal Body Temperature charts were biphasic and consistent with the L.H. surge results. The control group who used the subjective detection were only 55% successful. Conclusions: Collecting mucus directly from the cervix yielded a large quantity and excellent quality of (Spinnbarkeit). This allowed women to pinpoint the day of ovulation with astonishing precision. This shortened the fertile window to 4 days for conception and 9 days for contraception. The Synergy created between the vaginal conforming cap and a Smartphone application will provide the safest, most cost-effective birth control without side effects

A Case of Progestogen Hypersensitivity

Progestogen hypersensitivity (PH) is a cyclical dermatosis that occurs in fertile women during the luteal phase of the menstrual cycle. The clinical presentation is variable and non-specific. We report the case of a 42-year-old woman with a 10-year history of itchy skin lesions that recurred monthly. Determined with her basal body temperature chart, her skin symptoms were related to progesterone surges. Skin examinations revealed multiple and extensive monomorphic red papules, mainly on her arms and legs, as well as on her chest and back. She had no history of associated fever or dyspnea. Her hair, nails and mucous membranes were normal. A blood test at the time of the worst skin eruption revealed mild elevation of serum thymus and activation-regulated chemokines and eosinophilia. Her total serum IgE level was normal. She showed a delayed skin reaction to progesterone. Ultra-low-dose combined oral contraceptives (COCs) improved her symptoms by suppressing ovulation. Accordingly, a diagnosis of progestogen hypersensitivity was made. A T-helper (Th)2 response rather than a Th1 response was suggested to be involved in this case. Atopic dermatitis (AD) can be classified into the major extrinsic type with high serum IgE levels and the minor intrinsic type with normal IgE levels. PH and AD share similarities in that they present with eczema, IgE-mediated sensitization and delayed hypersensitivity responses, and their pathophysiology remains to be fully elucidated because of their heterogeneous aspects. The symptoms of this case were in line with IgE-low AD rather than IgE-high AD, which implicates endogenous progesterone as a trigger.

Does Luteal Phase Deficiency Exist and What is its Association with Infertility?

Jones studied the luteal phase by evaluating basal body temperature charts, urinary pregnanediol excretion (48-hour urine collection at the peak of luteal phase by basal body temperature), cervical mucus, and most importantly, timed endometrial biopsies. In the initial study, Jones evaluated 255 cycles in 98 women with infertility that was not due to tubal, uterine, anovulation or male factor.

A Specific Pattern in the Basal Body Temperature Chart during the First Week of Pregnancy May Warn of a Miscarriage Crisis

We studied the efficiency of acupuncture for patients who were unable to give birth though they had experienced conventional infertility treatment for more than 2 years by medical specialists. We then investigated characteristics of difficult pregnancy cases with measurement of body temperature and observation of basal body temperature (BBT) charts. Thirty-three patients had acupuncture every week for more than 2 years and 17 of them delivered. At the same time, their cutaneous body temperature was measured at five locations. Moreover, patients and acupuncturists had a weekly discussion of the patient’s BBT chart. The delivery group showed more balanced and higher cutaneous body temperatures than the miscarriage and no pregnancy groups. The delivery group showed a smooth increase in the BBT chart while the miscarriage group showed a specific pattern in shifting temperatures from low to high zones. Acupuncture might suppress excess sympathetic dominance, which induced hyperthermia as well as interruption of pregnancy. Additionally, weekly discussion and medical advice could help patients. However, further study of males, healthy women, or larger, comparative studies exploring the social and cultural background of other countries were needed to add support to these factors.

Synchronised approach for intrauterine insemination in subfertile couples.

In many countries intrauterine insemination (IUI) is the treatment of first choice for a subfertile couple when the infertility work up reveals an ovulatory cycle, at least one open Fallopian tube and sufficient spermatozoa. The final goal of this treatment is to achieve a pregnancy and deliver a healthy (singleton) live birth. The probability of conceiving with IUI depends on various factors including age of the couple, type of subfertility, ovarian stimulation and the timing of insemination. IUI should logically be performed around the moment of ovulation. Since spermatozoa and oocytes have only limited survival time correct timing of the insemination is essential. As it is not known which technique of timing for IUI results in the best treatment outcome, we compared different techniques for timing IUI and different time intervals. To evaluate the effectiveness of different synchronisation methods in natural and stimulated cycles for IUI in subfertile couples. We searched for all publications which described randomised controlled trials of the timing of IUI. We searched the Cochrane Menstrual Disorders and Subfertility Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL) (1966 to October 2014), EMBASE (1974 to October 2014), MEDLINE (1966 to October 2014) and PsycINFO (inception to October 2014) electronic databases and prospective trial registers. Furthermore, we checked the reference lists of all obtained studies and performed a handsearch of conference abstracts. Randomised controlled trials (RCTs) comparing different timing methods for IUI were included. The following interventions were evaluated: detection of luteinising hormone (LH) in urine or blood, single test; human chorionic gonadotropin (hCG) administration; combination of LH detection and hCG administration; basal body temperature chart; ultrasound detection of ovulation; gonadotropin-releasing hormone (GnRH) agonist administration; or other timing methods. Two review authors independently selected the trials, extracted the data and assessed study risk of bias. We performed statistical analyses in accordance with the guidelines for statistical analysis developed by The Cochrane Collaboration. The overall quality of the evidence was assessed using GRADE methods. Eighteen RCTs were included in the review, of which 14 were included in the meta-analyses (in total 2279 couples). The evidence was current to October 2013. The quality of the evidence was low or very low for most comparisons . The main limitations in the evidence were failure to describe study methods, serious imprecision and attrition bias.Ten RCTs compared different methods of timing for IUI. We found no evidence of a difference in live birth rates between hCG injection versus LH surge (odds ratio (OR) 1.0, 95% confidence interval (CI) 0.06 to 18, 1 RCT, 24 women, very low quality evidence), urinary hCG versus recombinant hCG (OR 1.17, 95% CI 0.68 to 2.03, 1 RCT, 284 women, low quality evidence) or hCG versus GnRH agonist (OR 1.04, 95% CI 0.42 to 2.6, 3 RCTS, 104 women, I(2) = 0%, low quality evidence).Two RCTs compared the optimum time interval from hCG injection to IUI, comparing different time frames that ranged from 24 hours to 48 hours. Only one of these studies reported live birth rates, and found no difference between the groups (OR 0.52, 95% CI 0.27 to 1.00, 1 RCT, 204 couples). One study compared early versus late hCG administration and one study compared different dosages of hCG, but neither reported the primary outcome of live birth.We found no evidence of a difference between any of the groups in rates of pregnancy or adverse events (multiple pregnancy, miscarriage, ovarian hyperstimulation syndrome (OHSS)). However, most of these data were very low quality. There is insufficient evidence to determine whether there is any difference in safety and effectiveness between different methods of synchronization of ovulation and insemination. More research is needed.

The Role of Ultrasound in Ovulation Detection Compared To BBT and Other Methods

Background: The detection of timing of ovulation is an important step in the evaluation and management of subfertility. Ultrasonography plays a vital role in monitoring follicular growth. Aims: To assess the value of ultrasound scanning of the ovaries in the periovulatory period to detect ovulation and to correlate the results with basal body temperature (BBT) chart and other presumptive evidences of ovulation. Methods: In this prospective study, a total of 60 subfertile patients were selected from the outpatient department of obstetrics and gynaecology, BPKIHS, Dharan. BBT charting, midcycle abdominal pain record & premenstrual endometrial biopsy were performed in all patients i.e. in spontaneous ovulating and anovulating (induced later). Ultrasonographic periovulatory follicular tracking was usually started around 10th day of the cycle. The results were then correlated with BBT mainly and also with mittelschmerz and endometrial biopsy. Results: In this series fifty five patients, who demonstrated sixty ovulations (with failed inductions in five patients) were monitored for hundred ten cycles. The mean preovulatory follicular diameter was 20.55 mm and 21.76 mm in spontaneous and induced cycles respectively. Majority (36%) demonstrated ovulation by disappearance of follicles accompanied by increase in the amount of fluid in the pouch of Douglas (POD). In this study five cases (14.2%) out of thirty five showing biphasic BBT were anovulatoty. Whereas five cases out of twenty one showing monophasic BBT were ovulating. Amongst the inconclusive group, one (25%) patient was ovulating and the rest four (75%) were anovulatoty. Only 35% patients experienced midcycle pain. Ipsilateral pain was commoner (16.6%) than contralateral (6.6%) and central pain (11.6%). Conclusion: Ultrasonographic follicular tracking is a reliable method of ovulation detection. Ovulation precedes the initial rise in temperature in most women confirming the limited value of the rise in BBT as a predictor of ovulation.DOI: http://dx.doi.org/10.3126/njr.v3i2.9608 Nepalese Journal of Radiology Vol.3(2)July-Dec, 2013: 57-64

Ovulation detection mechanism—a microcomputer based approach

This paper presents a real-time microcomputer-based logger for measuring basal body temperature (BBT). BBT is the normal resting body temperature of a healthy person immediately upon waking in the morning. The temperature for women normally rises after ovulation due to hormonal changes. The temperature is logged real-time into the computer over a period and the BBT chart produced is used to predict ovulation. There is high correlation between the approach developed by this study and other standard measuring equipments—correlation of 0.9945with standard thermistor, and correlation of 0.9977 with standard thermocouple. This development enables privacy of use, allowing women to predict their ovulation status at a personal level.

A Method for Estimating the Day of Ovulation by Basal Body Temperature Chart

The method for estimating the day of ovulation by the basal body temperature fluctuation was studied and appraised. The temperature variation within 0.1°C above or below the mean basal body temperature of the first 10 menstrual days was defined as the hypothermic phasic range. When the basal body temperature rose and remained above hypothermic phase for 4 consequtive days, it is considered to have shifted into the hyperthermic phase and the day before a shift into the hyperthermic phase was estimated as the day of ovulation. Continuous measurement of urinary LH concentrations from early morning samples established the LH peak day. The accuracy of this method was examined by comparing the basal body temperature and urinary LH peak. In 36 cycles (69%) BBT fell within two days around when the ovulation was most likely to occur, and fell within 2 days before and after the LH peak in 46 cycles (88%). A slight scattering in the estimates was due to the influence of factors other than progesterone on the basal body temperature. This seems as insurmountable limit to using basal body temperature for this purpose. In absence of any other means than BBT to estimate the day of ovulation, our simple objective method is quite practical and useful.

A nonspecific disturbance of the gonadostat in women with transsexualism and isolated hypergonadotropism in the male-to-female disturbance of gender identity.

Principal parameters of gonadostat function were determined in 15 female-to-male (F-M) and 7 male-to-female (M-F) transsexual patients (T), all homosexuals. The data were compared with normal heterosexual controls of the respective sex. Anamnesis revealed prolongation of the menstrual cycles in F-M patients, mainly in those taking previously medication with depot-testosterone. However, also in patients with no previous medication the basal body temperature chart revealed anovulatory cycles (all 4 examined patients). In 8 of 9 patients (82.2%) with no previous medication an elevation of serum testosterone was found (63-600 ng/dl). No disturbances in gonadal functions were found in M-F group (semen analysis), serum testosterone was normal (328-710 ng/dl) except 1 case with reduced testosterone level (200 ng/ml). Both women and men with transsexualism revealed significantly higher mean basal serum concentration of LH in comparisons to controls (F-M: 23.14 +/- 16.16 vs 7.56 +/- 4.23; M-F 15.30 +/- 6.49 vs 5.75 +/- 3.66). No changes in basal serum FSH concentration were present. GnRH test (100 micrograms i.v.) revealed decreased evocability of LH in woman with T and exaggerated LH response in men with T. FSH hyperresponse to GnRH was nonsignificant in F-M and significant in M-F T. It is concluded that F-M transsexualism is associated with nonspecific disturbances of gonadostat since hypergonadotropism coexists with the signs of impaired gonadal function. In M-F T and isolated hypergonadotropism coexisted with specific, increased sensitivity of the pituitary to GnRH.

Diagnostic tests in reproductive medicine

The aim of the fertility work-up is to exclude recognised causes of infertility and to distinguish those couples who have good spontaneous pregnancy prospects from those who have poor prospects. Information gathered by medical history, clinical findings and results of the diagnostic tests should help the clinician in counselling subfertile couples. The initial diagnostic tests for infertility should include a basal body temperature chart or midluteal phase progesterone level, a semen analysis and a test for tubal patency. Ovarian reserve tests can be used in selected cases. More research is needed in the predictive value of the outcome of diagnostic tests in reproductive medicine.

Interpretation of the BBT chart: using the “Gap” technique compared to the Coverline technique

Objective The aim of the study was to compare the accuracy of the Gap and Coverline techniques of interpreting the basal body temperature chart. Methods We compared the proportion of menstrual cycles for which the Gap and Coverline techniques accurately identified the post-ovulatory final fertile phase (FFP) and the initial infertile phase (IIP) and the median number of days each overestimated the fertile period, using urinary LH testing as the gold standard. Results The Gap and Coverline techniques identified the FFP within ±1 day of that identified by LH testing in 13/33 (39%) and 10/33 (30%) cycles ( χ 2=0.6; p=.44), respectively, and the IIP within +1 day of that of LH testing in 13/33 (55%) and 4/33 (12%) cycles, respectively ( χ 2=13.4; p<.001). The Gap and Coverline techniques overestimated the fertile period by 1 and 4 days, respectively (p=.0002). Conclusion Based on this small study, the Gap technique appears to be more accurate than the Coverline technique in identifying the post-ovulatory IIP.

Reliability of Ovulation Tests in Infertile Women

In Brief Objective To assess the reliability of the most widely used clinical methods for predicting or confirming ovulation. Methods We monitored spontaneous cycles in 101 infertile women using basal body temperature (BBT), transvaginal ultrasound, a urinary stick system for LH surge, and three serum progesterone measurements in the midluteal phase. Transvaginal ultrasound monitoring was standard for ovulation detection and sensitivity. We calculated specificity and accuracy of each method compared with that standard. Results Follicular development and ultrasound evidence of ovulation were confirmed in 97 of 101 cycles (96%). Urinary LH surge preceded follicular rupture assessed by ultrasonography in all cycles and showed concordance with ultrasound-evidenced ovulation in 98 of 101 cases. The timing of BBT nadir had wide variability, and BBT and ultrasonography agreed in a similar percentage of cases (74%). Midluteal serum progesterone assessments showed ovulatory values in 93 subjects, and ovulation was concordant with ultrasonography in 90 subjects. Conclusion Urinary LH was accurate in predicting ovulation with ultrasonography as the standard for detection, but time varied widely. The nadir of BBT predicted ovulation poorly. The BBT chart was less accurate for confirming ovulation, whereas a single serum progesterone assessment in midluteal phase seemed as effective as repeated serum progesterone measures. Ultrasonography, urinary LH surge detection, and serum progesterone assessment seem to be the most effective methods for predicting and confirming ovulation.

Reliability of ovulation tests in infertile women

Objective: To assess the reliability of the most widely used clinical methods for predicting or confirming ovulation. Methods: We monitored spontaneous cycles in 101 infertile women using basal body temperature (BBT), transvaginal ultrasound, a urinary stick system for LH surge, and three serum progesterone measurements in the midluteal phase. Transvaginal ultrasound monitoring was standard for ovulation detection and sensitivity. We calculated specificity and accuracy of each method compared with that standard. Results: Follicular development and ultrasound evidence of ovulation were confirmed in 97 of 101 cycles (96%). Urinary LH surge preceded follicular rupture assessed by ultrasonography in all cycles and showed concordance with ultrasound-evidenced ovulation in 98 of 101 cases. The timing of BBT nadir had wide variability, and BBT and ultrasonography agreed in a similar percentage of cases (74%). Midluteal serum progesterone assessments showed ovulatory values in 93 subjects, and ovulation was concordant with ultrasonography in 90 subjects. Conclusion: Urinary LH was accurate in predicting ovulation with ultrasonography as the standard for detection, but time varied widely. The nadir of BBT predicted ovulation poorly. The BBT chart was less accurate for confirming ovulation, whereas a single serum progesterone assessment in midluteal phase seemed as effective as repeated serum progesterone measures.

High Ovulatory Rates With Use of Troglitazone in Clomiphene-Resistant Women With Polycystic Ovary Syndrome

This preliminary report reviews our experience with 18 infertile patients with clomiphene-resistant polycystic ovary syndrome (PCOS). In the first treatment cycle, troglitazone was administered alone. During cycles 2-5, clomiphene was added with increments of 50 mg (up to 200 mg/day) if the previous cycle was anovulatory. Basal body temperature charts and serum progesterone were obtained to confirm ovulation. In a total of 66 treatment cycles, ovulation occurred in 44 (67%) and pregnancy in seven (11%). There were no significant changes in body weight, waist:hip ratio or liver enzymes during treatment. Troglitazone, alone or with clomiphene, induced ovulation in 15 of 18 patients (83%) and seven (39%) of them achieved pregnancy. This is the first report on ovulatory rates in clomiphene-resistant women with PCOS when troglitazone was used alone or with clomiphene. Recently, metformin and clomiphene were successfully used in women with PCOS. However, our patients represent a more resistant population of women with PCOS, with each patient serving as her own historical control by previous resistance to clomiphene. Although the pregnancy rate (39%) was promising for clomiphene-resistant women with polycystic ovary syndrome, it does not seem to have a definite advantage over gonadotrophins.

High ovulatory rates with use of troglitazone in clomiphene-resistant women with polycystic ovary syndrome.

This preliminary report reviews our experience with 18 infertile patients with clomiphene-resistant polycystic ovary syndrome (PCOS). In the first treatment cycle, troglitazone was administered alone. During cycles 2-5, clomiphene was added with increments of 50 mg (up to 200 mg/day) if the previous cycle was anovulatory. Basal body temperature charts and serum progesterone were obtained to confirm ovulation. In a total of 66 treatment cycles, ovulation occurred in 44 (67%) and pregnancy in seven (11%). There were no significant changes in body weight, waist:hip ratio or liver enzymes during treatment. Troglitazone, alone or with clomiphene, induced ovulation in 15 of 18 patients (83%) and seven (39%) of them achieved pregnancy. This is the first report on ovulatory rates in clomiphene-resistant women with PCOS when troglitazone was used alone or with clomiphene. Recently, metformin and clomiphene were successfully used in women with PCOS. However, our patients represent a more resistant population of women with PCOS, with each patient serving as her own historical control by previous resistance to clomiphene. Although the pregnancy rate (39%) was promising for clomiphene-resistant women with polycystic ovary syndrome, it does not seem to have a definite advantage over gonadotrophins.

Comparison of low-technology and high-technology monitoring of clomiphene citrate ovulation induction

Objective: To determine whether newer monitoring techniques, including urinary detection of the LH surge and vaginal ultrasound, offer an advantage over basal body temperature (BBT) charts alone in achieving pregnancy using clomiphene citrate (CC). Design: Randomized clinical trial. Setting: Infertility patients in an academic research environment. Patient(s): Forty-five women undergoing ovulation induction with CC. Intervention(s): The women were assigned randomly to receive either low- or high-technology ovulation monitoring for a total of 3 ovulatory cycles. Both groups were followed with BBT charts. The high-technology group also was monitored with urinary LH kits and vaginal ultrasound. Main Outcome Measure(s): Cycle fecundity rates for each technique were compared statistically with use of life-table analysis. Result(s): Forty-five patients were studied during a total of 134 cycles. The overall cycle fecundity rate was 8%, 10% (8 of 81 cycles) for the low-technology monitoring group and 6% (3 of 53 cycles) for the high-technology monitoring group. These rates were not statistically significant when evaluated by Fisher’s exact test ( P = .53) or when using life-table analysis and a log-rank test ( P = .48). Conclusion(s): These data suggest that, for initial attempts at ovulation induction with CC in unselected patients, high-technology monitoring of ovulation offers no increase in fecundity over low-technology monitoring.

Hypofertility With Thick Cervical Mucus: Another Mild Form of Cystic Fibrosis?

To the Editor. —Male infertility due to congenital bilateral absence of the vas deferens (CBAVD) is frequently recognized as a mild form of cystic fibrosis (CF). 1,2 However, CF with primarily genital involvement may not be limited to males. Report of a Case. —We recently observed a 40-year-old woman with a medical history of infertility. She used oral contraceptives from 1974 to 1978. In 1975, she had electrocoagulation for ectropion. From 1981 to 1986, she had unprotected sexual intercourse but could not become pregnant. In 1986, she and her husband underwent investigations for infertility. Her husband's semen analysis was normal. Ovulation was confirmed by biphasic basal body temperature charts. Hysterosalpingogram was normal. The only consistent abnormality was found in postcoital tests. On 3 separate cycles, repetitive testing revealed tenacious mucus, which did not vary according to the time of cycle and contained no motile sperm. Testing for antisperm antibodies was

Evaluation of hormonal testing in the screening forin vitro fertilization (IVF) of women with tubal factor infertility

To evaluate the frequency of abnormal prolactin and thyroid stimulating hormone (TSH) test results in ovulatory women with tubal factor infertility who were screened for in vitro fertilization (IVF). Charts were identified from 112 ovulatory women with follicle stimulating hormone (FSH) < 20 mIU/ml who were diagnosed with tubal factor infertility and were screened for IVF with thyroid stimulating hormone (TSH) and prolactin levels. Women previously diagnosed with thyroid disease were subsequently excluded and 98 subjects remained. All subjects were determined to be ovulatory by biphasic basal body temperature (BBT) charts, luteal phase progesterone > 4 ng/ml, or endometrial biopsy revealing secretory endometrium. Results of cycle day 3 serum TSH and prolactin concentrations were recorded. The normal range for each test reflects the geometric mean +/- 2 standard deviations (i.e., 95% interval), as obtained from the reference laboratory. Under this construct, hypothesis tests were performed to determine whether or not our study population was consistent with the reference range of normal hormone levels. Under the null hypothesis (normal levels), we expected 5% of the TSH tests to be abnormal (i.e., high or low levels), and 2.5% of the prolactin tests to be abnormal (i.e., high levels). Exact bionomial confidence intervals and P-values were calculated. We also tested for age trend in the proportion of abnormal results. Study subjects had an age range of 25-43. In the study group, 4 (0.041) out of the 98 women screened had abnormal TSH levels. Of these four abnormal TSH results, three were elevated (i.e., TSH > 4.6 microIU/ml) and one was low (i.e., TSH < 0.6 microIU/ml). The frequency of an abnormal TSH value was not significantly different from that expected from the reference laboratory normal values (95% CI 0.011, 0.101). Of the 98 subjects, 7 (0.071) had abnormal prolactin levels, which was significantly different from that expected from the reference laboratory normal values (95% CI 0.029, 0.142; P = 0.023). When stratified by age, there was no observed trend of abnormalities for TSH or prolactin levels with increasing age. In ovulatory women presenting for IVF with tubal factor infertility, our results show that routine screening with a TSH test does not yield a significantly higher proportion of abnormal results than that expected from the reference laboratory normal values. However, prolactin level screening was found to yield a higher incidence of abnormal tests than expected from the reference laboratory normal values.

Endometriosis and luteal phase defect.

It has been reported that there exists a correlation between endometriosis and the luteal phase defect (LPD) as one of the determinants in infertility. In some theories, the hampered maturation of the corpus luteum is believed to be caused by the reduction of LH receptors, increase in prolactin, prostaglandin and macrophages in endometriosis. The purpose of this clinical study is to prove the hypothesis that there exists a significant correlation between endometriosis and the luteal phase defects in infertility. The samples were taken at random from 150 women with infertile marriages on whom ovulation was assumed to have occurred, from January 1981 to December 1985. The assumption that there might have occurred ovulation is determined through the observation of their basal body temperature (BBT) chart. Endometrium biopsies to diagnose the LPD were taken at the end of their luteal phase. A laparoscopy examination to diagnose the pelvic endometriosis was done in the following cycle. Of 84 patients with endometriosis, 44 (55.4%) had luteal phase defects, while the remaining 40 (47.6%) patients had no luteal phase defects. Of the 66 patients without endometriosis, 27 (40.9%) had luteal phase defects, while the remaining 39 (59.1%) did not have luteal phase defects. These differences were not significant (p > 0.05). In summary, this clinical study fails to show the existence of significant correlation between endometriosis and the luteal phase defect.

The effect of clomiphene citrate treatment on cervical mucus and plasma estradiol and progesterone levels

To study the relationship between cervical mucus (CM) quality, postcoital test (PCT) results and plasma estradiol (E2) in clomiphene citrate (CC)-treated women. A subsidiary aim was to study the relationship between CM quality and plasma progesterone (P). Untreated women were compared with oligo-ovulatory patients given CC. Infertility Clinic, Fazakerley Hospital, United Kingdom. Fifty-one untreated patients and 31 women given CC. The treated women were given 50 mg/d CC from days 2 to 6 of their cycle. A CM assessment, a PCT, plasma E2, and P were performed at the anticipated time of ovulation based on at least two previous basal body temperature charts and menstrual patterns. In untreated women there was a very strong tendency for CM quality to improve with rising plasma E2 levels and to worsen with rising plasma P levels. There was a significant association between CM quality and PCT results. Similar results were found in CC-treated women, except that plasma E2 was very significantly higher and there was a significant inverse relationship between plasma E2 and CM quality. High plasma E2 in the periovulatory phase in CC-treated women is a marker for increased sensitivity to and continuing action of the antiestrogen. This impairs the quality of the CM.