Eissa, M. K., Sawers, R. S., Docker, M. F., Lynch, S. S., & Newton, J. R. (1987). Characteristics and incidence of dysfunctional ovulation patterns detected by ultrasound. Fertility and Sterility, 47(4), 603-612. https://doi.org/10.1016/s0015-0282(16)59110-9
Eissa MK, Sawers RS, Docker MF, Lynch SS, Newton JR. Characteristics and incidence of dysfunctional ovulation patterns detected by ultrasound. Fertil Steril. 1987;47(4):603-612. doi:10.1016/s0015-0282(16)59110-9
Eissa, Moustafa K., et al. "Characteristics and incidence of dysfunctional ovulation patterns detected by ultrasound." Fertility and Sterility, vol. 47, no. 4, 1987, pp. 603-612.
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Abnormal ovulation appeared in 58% of unexplained infertility cycles
A 1987 study tracked ovulation with ultrasound and hormone tests in 45 women with unexplained infertility. About 6 out of 10 of their cycles showed abnormal ovulation. In 15 women using donor insemination, about 2 out of 10 cycles showed it. The study covered 136 cycles and found four abnormal patterns.
Study at a glance: Abnormal ovulation appeared in 58% of unexplained infertility cycles. Source: Eissa MK et al., 1987, PMID 3106099.
Key Findings
Abnormal cycles made up 58% (56/97) of cycles in the 45 infertile women and 23% (9/39) in the 15 donor insemination women (P < 0.001).
Of 60 abnormal cycles, none ended in conception. Conception occurred in 11 of 51 cycles that looked entirely normal.
In the infertile group, LUF cycles made up 20% (19/97), cyst cycles 22% (21/97), asynchronous cycles 8% (8/97) and no-follicle cycles 8% (8/97).
Of 26 women with abnormal cycles and at least three cycles tracked, 13 (50%) showed one abnormality, 12 (46%) showed two, and 1 showed three.
When a woman's first two cycles were normal, the third agreed in 8 of 11 (73%). When the first two were abnormal, the third agreed in 4 of 11 (36%).
Interpretation
This study tracked 45 women with unexplained infertility and 15 women using donor insemination. Doctors used ultrasound to check 136 cycles at a Birmingham clinic. Abnormal ovulation was linked to a sharp drop in pregnancy. None of the 60 abnormal cycles led to pregnancy. Pregnancy happened in 11 of 51 normal-looking cycles. The authors note the cause of the abnormal patterns is still unclear. The findings support larger studies that track ovulation across many cycles in women with unexplained infertility.
RRM Context
Restorative reproductive medicine treats unexplained infertility as undiagnosed infertility. The authors write that the LUF pattern can be seen only with ultrasound. They say one cycle is not enough to diagnose it. Checking ovulation cycle by cycle helps find the cause. Cycle charting shows which cycles looked different.
Our editorial summary of this paper, not the article's abstract.
Abstract
The nature and incidence of normal and abnormal spontaneous ovarian cycles, identified with ultrasound and endocrine tracking, were examined in 45 regularly cycling infertile women with no definitive cause and 15 women who were apparently normal and were receiving donor insemination because of clearly infertile partners. In 136 cycles, four apparently distinct abnormal patterns were detected. The total incidence in the infertile group was 58% compared with 23% in the donor insemination group (P less than 0.005). Twelve of 26 subjects who had at least three cycles tracked showed two different abnormalities, and 1 subject had three different abnormalities in five abnormal cycles. These results suggest that abnormal cycles are a significant factor in unexplained infertility and that diagnosis and treatment cannot be based on the study of a single cycle.
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