Chapter 21: Disorders of Human Ovulation: Endocrine Validation of the Sonographic Classification System

Hilgers TW

Reproductive Endocrinology Ovulation Physiology

Chapter 21: Disorders of Human Ovulation: Endocrine Validation of the Sonographic Classification System

Hilgers TW

The Medical and Surgical Practice of NaProTECHNOLOGY, 269-274, 2004

RRM Academy Synopsis

Six ultrasound-defined ovulation disorders all show lower progesterone

Cycles with any of six ovulation disorders had lower progesterone after ovulation. A NaProTechnology textbook chapter tracked them on ultrasound and compared them with 57 normal cycles. Estradiol near ovulation was lower in five of the six.

Key Findings

Each of six ultrasound-defined ovulation disorders was compared with 57 control cycles that showed a mature follicle and complete rupture.
Post-Peak progesterone sums and means were significantly lower than the control group in each of the six disorders.
Estradiol around ovulation was significantly lower than control at one or more points in every disorder except delayed rupture.
Partial rupture and afollicular cycles had the most reduced estradiol around ovulation. Immature follicle, luteinized unruptured follicle and empty follicle cycles showed less.
Luteal phase estradiol showed only minimal dysfunction compared with periovulatory estradiol or luteal phase progesterone.

RRM Context

NaProTechnology pairs Creighton Model FertilityCare System (CrMS) charting with serial ultrasound and blood tests timed from the charted Peak Day. The chapter is the program's own report of that combination. Restorative reproductive medicine asks why ovulation goes wrong before treating it. A classification tied to hormone patterns gives that question a specific answer for each cycle.

Our editorial summary of this paper, not the article's abstract.

Abstract

This chapter, the second of three, correlates serum estradiol and progesterone levels with the anatomic disorders of ovulation identified by serial follicular ultrasound in the previous chapter. Hormone profiles for each disorder, timed to the Peak Day charted with the CREIGHTON MODEL FertilityCare System (CrMS), were compared with a control group of cycles showing an anatomically normal ovulation by ultrasound. Every disorder except the delayed rupture pattern showed significant periovulatory estradiol dysfunction, all six disorders showed decreased post-Peak progesterone production, and luteal phase estradiol showed only minimal dysfunction. Hilgers concludes that each of the six anatomic disorders carries a defined functional disturbance, which appears to be a follicular dysfunction followed by a luteal dysfunction.

Topics

Reproductive Endocrinology › Ovulation Physiology › Ovulation Disorder Classification · Diagnostics › Hormone Testing › Timing of Testing · Menstrual Cycle › Cycle Disorders › Ovulatory Disturbances

Thomas W Hilgers

Tom Hilgers, T Hilgers

Hilgers et al. 2004, Hilgers 2004

Chapter 21: Disorders of Human Ovulation: Endocrine Validation of the Sonographic Classification System

Six ultrasound-defined ovulation disorders all show lower progesterone

Key Findings

RRM Context

Abstract

Topics

By this author

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