Basal Body Temperature Charts Research Articles

CA-125 and placental protein 14 concentrations in plasma and peritoneal fluid of women with deeply infiltrating pelvic endometriosis

To investigate the plasma and peritoneal fluid (PF) concentrations of CA-125 and placental protein (PP14) in women with deeply infiltrating endometriosis. Plasma and PF were collected during 384 consecutive laparoscopies for pelvic pain or infertility. The presence and extent of endometriosis were carefully assessed, including the area, depth of infiltration, and volume of subtle lesions, typical lesions, and endometriomas. The day of the menstrual cycle was ascertained by endometrial biopsy and/or basal body temperature charts. Peritoneal fluid concentrations were some 100 and 10 times higher than plasma concentrations for CA-125 and PP14, respectively. Cyclic variations of CA-125 concentrations were only found in women with endometriosis showing increased plasma concentrations at the end of the cycle and increased PF concentrations in the early follicular phase. Cyclic variations of PP14 concentrations were found in women with and without endometriosis both in plasma and PF showing increased concentrations in the late luteal and early follicular phases. In women with endometriosis the increased plasma concentrations of PP14 and CA-125 correlated with the presence and volume of endometriomas and of deeply infiltrating endometriosis. The increased concentrations in PF correlated only with the pelvic area of subtle endometriotic lesions. The diagnostic sensitivity and specificity of CA-125 for endometriosis were 25% and 87%, respectively, and for endometriomas and/or deeply infiltrating endometriosis 36% and 87%, respectively, for a cutoff concentration of 25 U/mL. Superficial pelvic endometriosis secretes PP14 and CA-125 mainly toward the PF, whereas endometriomas and deeply infiltrating endometriosis secrete mainly toward the plasma. The increased plasma concentrations of CA-125 are most pronounced during the late luteal phase, and endometriomas and/or deeply infiltrating endometriosis can be detected with a sensitivity of 36% and a specificity of 87%.

A PROSPECTIVE STUDY OF THE MENSTRUAL CYCLE AND SPINAL CORD INJURY

Sixty seven menstrual cycles were studied prospectively in a nonclinical sample of 20 women who had suffered a traumatic spinal cord injury (quadriplegia n = 13; paraplegia n = 7) at least 1 yr before assessment. Level of injury did not influence cycle length (mean +/- SE = 28.7 +/- 3 days), duration of menses (4.6 +/- 1 days) or serum concentrations of gonadotropins and ovarian hormones. Midluteal phase serum progesterone values were consistent with ovulation (progesterone = greater than 5 ng/ml) in 93% of the cycles in which endocrine measures were obtained; but the ability of basal body temperature pattern to predict serum progesterone was low (43%). Cyclic dysmenorrhea was reported by 13 women with injuries ranging from C5 to T12. These findings suggest that ovulatory menstrual cycles are common in women after traumatic spinal cord injury and support the need for contraception by those wishing to avoid pregnancy. Basal body temperature charts revealed potential problems in applying the symptothermal method of natural family planning to a population of women at risk for oral contraceptives.

Serial Changes of Serum CA125 Levels during Menstrual Cycles

Serial changes of serum CA125 levels during 32 menstrual cycles were examined in 32 healthy young women (19-21 years of age) charting basal body temperature (BBT) and measuring serum estradiol and progesterone levels. Analysis of BBT charts and serum progesterone levels revealed that the 32 menstrual cycles could be classified into either an ovulatory cycle with a sustained BBT temperature increase for at least 10 days (type I: 9 cycles), an ovulatory cycle with a sustained BBT temperature increase for less than 10 days (type II: 17 cycles), or anovulation (type III: 6 cycles). All 32 cycles exhibited basal CA125 levels of less than 35 u/ml throughout the cycle, except during the period of menstruation. At menstruation, 7 of the 9 cycles of type I showed a marked, transient elevation of CA125 levels from previous basal levels (a mean net increase). On the other hand, 12 of 17 cycles of type II showed only a slight elevation of CA125 levels during the period of menstruation. None of the 6 cycles of type III showed any apparent increase in CA125 levels during the period of menstruation. The mean net increase of CA125 levels during the period of menstruation in the cycles of type I was significantly higher than that of the cycles of type II (p less than 0.05) and type III (p less than 0.05). These results imply that a transient elevation of serum CA125 levels during the period of menstruation occurs in cycles with ovulation, and the levels of elevation seem to be closely associated with the duration of the sustained BBT temperature increase.

Basal body temperature and endometriosis

This investigation examined the association between pelvic endometriosis and altered basal body temperature (BBT). The study population consisted of infertile women who have been diagnosed as having endometriosis. A significant association was found between the presence of pelvic endometriosis (without previous treatment) and the appearance of a late decline in BBT during the early follicular phase of the menstrual cycle. A temperature greater than 97.8 degrees F on the first 3 days of menses is associated with pelvic endometriosis. The findings of this study support the early clinical diagnosis of endometriosis in infertile women. Basal body temperature chart analysis may be useful as a clinical adjunct when endometriosis is suspected.

Evaluation of the accuracy of the home ovulation detection kit, Clearplan, at predicting ovulation

A home ovulation testing kit, Clearplan, that detects the urinary luteinizing hormone (LH) surge was compared with basal body temperature (BBT) charts and cervical scoring as a method of ovulation prediction in 54 consecutive patients. The accuracy of all these methods was evaluated using daily serum LH measurements. Clearplan was shown to be significantly more accurate at timing ovulation than were BBT charts (P less than 0.0001) and cervical scoring (P less than 0.025). In 82%-88% of cases the kit predicted ovulation within one day and in 89%-96% of cases within two days of the serum LH surge. The kits were found to be easy to use and their potential place in clinical practice is discussed; home ovulation testing may ultimately replace serum LH assays as the method of choice in timing ovulation.

A prospective randomized controlled trial comparing urinary luteinizing hormone dipsticks and basal body temperature charts with time donor insemination

International Journal of Gynecology & ObstetricsVolume 31, Issue 4 p. 386-386 Citations from the literature fertility and sterility A prospective randomized controlled trial comparing urinary luteinizing hormone dipsticks and basal body temperature charts with time donor insemination CLR Barratt, CLR BarrattSearch for more papers by this authorS Cooke, S CookeSearch for more papers by this authorM Chauhan, M ChauhanSearch for more papers by this authorID Cooke, ID CookeSearch for more papers by this author CLR Barratt, CLR BarrattSearch for more papers by this authorS Cooke, S CookeSearch for more papers by this authorM Chauhan, M ChauhanSearch for more papers by this authorID Cooke, ID CookeSearch for more papers by this author First published: April 1990 https://doi.org/10.1016/0020-7292(90)90945-HCitations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume31, Issue4April 1990Pages 386-386 RelatedInformation

A prospective randomized controlled trial comparing urinary luteinizing hormone dipsticks and basal body temperature charts with time donor insemination

Especially now with the almost exclusive use of frozen semen, accurate timing of donor inseminations is an important point to address if a successful donor insemination program is to be established. To examine whether the timing of donor inseminations using urinary luteinizing hormone (LH) dipsticks (group 2) was significantly better than using basal body temperature (BBT) charts (group 1) we performed a prospective randomized controlled trial. There was no significant difference between the cumulative pregnancy rates at 6 months (0.23 versus 0.31 for groups 1 and 2, respectively) or the monthly fecundability (0.04 versus 0.07 for groups 1 and 2, respectively). Using these monthly fecundabilities we have calculated that approximately 378 patients in each arm of the trial would be needed to demonstrate a significant difference between the two groups. We therefore conclude that timing donor inseminations using urinary LH dipsticks does not significantly improve the conception rates.

Luteinizing hormone and ovulation timing in a therapeutic donor insemination program using frozen semen

A series of 110 therapeutic donor insemination cycles was analyzed to determine the impact on fecundity when a urinary luteinizing hormone detection kit was used to plan inseminations. To prevent the transmission of human immunodeficiency virus, frozen semen, thawed after a 90-day quarantine, was used. The minimum standard for insemination with cryopreserved semen was a total of 24 x 106 motile sperm per milliliter after thawing. Fecundity was 0.12 when insemination timing was based on cervical mucus evaluation and basal body temperature charts and 0.13 when a urinary luteinizing hormone kit was also used to predict ovulation. Life table analysis with the log rank test showed no statistically significant difference in the number of cycles required to achieve conception betwen the group of patients using conventional methods of ovulation timing and the group of patients using the urinary luteinizing hormone kit. Urinary luteinizing hormone testing offers no advantage over conventional methods, such as cervical mucus examination and evaluation of basal body temperature, when ovulation is being timed for insemination with frozen donor semen. (Am J Obstet Gynecol 1989;160:1169-72.)

Monitoring of ovulation in the assessent of reproductive hazards in the workplace

If women are exposed to reproductive hazards in the workplace, some disturbances of ovulation are expected. Assessment of ovulation requires monitoring to distinguish normal and abnormal ovarian cycles. Menstrual interval and basal body temperature charts are inadequate for identifying many abnormal cycles. A late-luteal endometrial biopsy or a single mid-luteal morning progesterone level each appears to be only 80% accurate in distinguishing normal and abnormal cycles. The complete “cycle profile” of daily ovarian ultrasonic scans and daily serum levels of reproductive hormones appears to be a definitive approach to characterizing ovarian cycles, but this demanding regimen would not be applicable to monitoring large populations in the workplace. An ovarian cycle monitoring protocol consisting of daily measurement of salivary or vaginal electrical resistance, mid-cycle urine testing for the luteinizing hormone surge, and daily luteal phase salivary progesterone levels would provide a practical comprehensive corroborative assessment of ovarian cycles in such populations of women. This monitoring of ovarian cycles would aid in the early detection of reproductive hazards and medical conditions that might present as an ovulatory disturbance.

Identification and management of clomiphene citrate responses

Clomiphene citrate (CC) is widely used for induction of ovulation; however, adequate time is rarely used to monitor patients on this form of therapy. Two hundred thirty-one infertility patients qualified for this study in 1155 cycles, during which basal body temperature charts were kept and the quality of cervical mucus was evaluated. Nine types of responses were classified: three ovulatory (O 1 , O 2 , O 3 ), three anovulatory (A 1 , A 2 , A 3 ), and three miscellaneous (M 1 , M 2 , M 3 ). The overall, uncorrected pregnancy rate was 54.9%, and 79.2% showed ovulatory responses. The most common response was O 1 (normal responses, 38.5%) with the highest pregnancy rates (92.1%). Poor estrogenic response with poor cervical mucus (CM) (O 2 ) was fairly common (13.4%) and had poor pregnancy rates, even with the addition of estrogens (12.9%). It is suggested that this new classification of CC responses will help to identify and more efficiently manage patients undergoing this form of therapy.

Inaccuracy of basal body temperature charts in predicting urinary luteinizing hormone surges

Sixty basal body temperature (BBT) charts were reviewed by three reproductive endocrinologists in an attempt retrospectively to predict the urinary luteinizing hormone (LH) surge. LH surges had been previously detected in all cycles with the use of a commercially available monoclonal antibody kit, Ovustick (Monoclonal Antibodies, Inc., Mountain View, CA). Surges were correctly predicted to the day (day 0) 18.3% to 30.0% of the time, to within 1 day on either side of day 0 56.7% to 70.0% of the time, to within 2 days 83.3% to 98.3% of the time, and to within 3 days 96.7% to 98.3% of the time. The BBT remains an inaccurate predictor of the day of the LH surge but does provide a reasonably accurate guide to the 2- to 3-day period on either side of the surge.

Ovulatory disturbances: Causative factors among japanese student nurses in a dormitory

The incidence of ovulatory disturbances in student nurses living in a restricted circumstance was evaluated by observing a basal body temperature (BBT) chart recorded for three to nine months by all of the student nurses in our medical college. The students were 18-21 years of age and were all living in a school dormitory. One hundred of the 154 students (64.9%) were anovulators during the school term. However, 40 of the anovulators showed ovulatory cycles with biphasic BBT patterns during their spring and/or summer holidays. The subjects' living conditions were investigated by questionnaire. Age of menarche, sport activity, self-perceived physical and mental work load, and native region did not appear to be related to their ovulatory disturbances. Weight-height-derived indices indicated that the anovulators had a tendency to corpulence as compared to the regular ovulators. Serum luteinizing hormone, follicle stimulating hormone, and prolactin levels of the anovulators were not significantly different from the regular ovulators.

Long-term luteal changes after tubal sterilization

In this study the luteal function was evaluated in 109 subjects 2 to 108 months following tubal sterilization by Pomeroy's technique or laparoscopic tubal rings. Midluteal endometrial biopsies determined by basal body temperature charts were performed and dated in all subjects. Midluteal serum progesterone was estimated by RIA in 40 women. Our results indicated that the mean time which had elapsed since sterilization was significantly shorter in the subjects who revealed luteal defects than in those with normal luteal function. There were no statistically significant differences between the 2 occlusive techniques in terms of poststerilization incidence of luteal defects.

A critical evaluation of subfertility investigations.

AbstractHo PC, Tang GWK and Ma HK (Department of Obstetrics and Gynaecology, University of Hong Kong, Hong Kong). A critical evaluation of subfertility investigations.The investigations done for the infertile couple attending the Subfertility Clinic of the Hong Kong University Gynaecological Unit from 1975 to 1979 were reviewed. The Rubin's tubal insufflation test has been replaced partly by laparoscopy which was found to be the more accurate and informative method of tubal assessment. Basal body temperature charts were not accurate in the diagnosis of luteal phase defect. In 22% of patients, endometrial biopsy specimens were inadequate or could not be obtained because of technical difficulty and failed to give the information required. A seminal count of less than 20 million per ml was found to be indicative of decreased fertility of the male partner. Despite the increase in the number and varieties of investigations, there was little improvement in the overall pregnancy rate.

Delayed endometrial maturation in women with normal progesterone levels. The dysharmonic luteal phase syndrome.

In 121 women attending the infertility clinic between 1978 and 1982, 127 cycles with luteal phases of 10 days or more were investigated by a complete basal body temperature (BBT) chart, three plasma progesterone assays taken between 11 and 4 days before menses, and a dated endometrial biopsy (EB) taken at the time of the last blood sample. All parameters were normal in 78 women (64.4%) categorized as group I 'normal luteal phases (NLP)'. There were some discordances between the three parameters in the remaining 43 women: 8 had normal BBT but low progesterone levels and delayed EB. They form group II 'inadequate luteal phases'. 29 women (23.9%) had delayed EB despite normal progesterone levels: forming group III 'dysharmonic luteal phases (DLP)'. 6 women had advanced EB and normal progesterone levels: group IV. Apart from endometrial maturation, there was no difference between NLP and DLP, neither in clinical parameters (length of the follicular phase, date and duration of the thermal shift, length of the luteal phase), nor in progesterone levels. Fertilization occurred in four DLP biopsied cycles: pregnancies went normally to term, giving birth to normal babies. Therefore, the DLP syndrome, characterized by normal midluteal progesterone levels and a delayed endometrial development, is not incompatible with normal nidation and gestation.

Basal body temperature graph and the luteal phase defect

Basal body temperature (BBT) charts from three menstrual cycles of 20 normal women and 20 women with biopsy-proven luteal phase defect (LPD) were reviewed. Mean luteal phase length in the normal women was 13.4 days, and that of the women with LPD was 11.8 days (P less than 0.05). Six (30%) of the LPD patients had luteal phases of less than 11 days according to BBT, and five of these patients had severely out-of-phase endometrial biopsies. None of the normal patients had luteal phases of less than 11 days. There was no significant difference in the mean rate of postovulatory BBT rise between the two groups. It is suggested that the slope of postovulatory temperature shift is not helpful in the diagnosis of LPD but that evidence of a luteal phase of less than 11 days on BBT does indicate a high likelihood of LPD.

Exposure to men influences the occurrence of ovulation in women

It has been demonstrated that exposure to men has the capacity to shorten the menstrual cycle in women. In the present study, the impact of the variables of sleeping arrangements and sexual activity were examined on both menstrual cycle length and the occurrence of ovulation as determined by basal body temperature charts. It was found that women who spent at least two or more nights with men during a forty day period exhibited a significantly higher rate of ovulation ( p<0.05) than those spending no or one nights. Cycle length was not affected by sleeping arrangements. Furthermore, frequency of sexual intercourse was unrelated to either cycle length or likelihood of ovulation. The mechanism underlying this phenomenon is unknown but it is conjectured that it is pheromonal in nature.

Failure of bromocriptine to restore the menstrual cycle in normoprolactinemic post-pill amenorrhea

A double-blind placebo-controlled randomized study to test the efficacy of bromocriptine in women with normoprolactinemic postpill amenorrhea (NPPA) is described. 29 patients had secondary amenorrhea of at least 6 months duration after discontinuation of oral contraceptives (OCs), plasma prolactin (PRL) 0.6mU/ml, no galactorrhea, no recognizable cause of anovulation after intensive endocrinologic screening, and no history of use of drugs known to interfere with PRL metabolism except OCs. The dosage of bromocriptine was 3 mg/day for 12 weeks or until the 2nd vaginal bleeding. PRL, estradiol, and progesterone levels were measured at 2-week intervals. All patients kept basal body temperature charts and registered vaginal bleeding. 13 women received bromocriptine daily for 10-12 weeks and 16 received placebos for 9-12 weeks. No significant differences in age, weight, menstrual cycles before OC use, duration of OC use, or duration of amenorrhea were observed between the 2 groups. Menstruation occurred in 4 women using bromocriptine; ovulation was likely in 1 of them according to the basal body temperature and/or progesterone levels in the luteal phase. Ovulation appeared likely in 8 of 9 women in the placebo group who reported bleeding. The results clearly show that bromocriptine has no effect on the restoration of menstruation in NPPA.

Investigative strategy of hyperandrogenism in women.

Investigative procedures in the assessment of female hyperandrogenism are reviewed. Based on their experience, the authors suggest an inexpensive investigative strategy in hyperandrogenic females consisting of the following: the first step depends upon the clinical symptoms--in cases of hirsutism with regular menstrual cycles, plasma testosterone (T) and plasma dehydroepiandrosterone sulfate (DHA-S) are assayed, and the basal body temperature chart is recorded. In cases of hirsutism with irregular or anovulatory menstrual cycles, in addition to T and DHA-S, plasma 17-hydroxyprogesterone and urinary-free cortisol are assayed. In case of anovulation without hirsutism, T and DHA-S are assayed, and the LHRH test is performed. The results of this first investigation allow to attribute to the woman one of the six following hormone profiles: (1) metabolic hyperadrenalism; (2) tumoral hyperandrogenism; (3) 21-hydroxylase defect; (4) nontumoral DHA-S increase; (5) nontumoral ovarian hyperandrogenism; (6) idiopathic hirsutism. The additional investigative procedures required in each of these groups are detailed.

The basal body temperature chart in artificial insemination by donor pregnancy cycles

The basal body temperature (BBT) charts in pregnancy cycles of 110 consecutive women who became pregnant by a single heterologous insemination were studied. The occurrence of ovulation was proved by the pregnancies in each case. All of these pregnancy charts showed a biphasic pattern, and most followed one of three stated types. The charts of 10 pregnancies that ended in miscarriage were no different from those 100 charts of pregnancies that proceeded to live births. No pregnancies occurred when artificial insemination by donor (AID) was performed before day 11 of the cycle or 2 or more days after the temperature elevation. Of 94 singleton pregnancies, 56 (60%) were male and 38 (40%) were female. This male predominance had not been noted previously. Knowledge of the appearance of a typical pregnancy chart is useful not only in the diagnosis of certain causes of infertility but also in the accurate timing of artificial insemination. Previous work on the association between the BBT chart and ovulation compared the chart with various tests of presumptive ovulation. In this series the charts were studied in ovulatory cycles proven by pregnancy.