Chronological aspects of ultrasonic, hormonal, and other indirect indices of ovulation

René Ecochard; Hans Boehringer; Muriel Rabilloud; Henri Marret

doi:10.1111/j.1471-0528.2001.00194.x

Menstrual Cycle · Cycle Biomarkers

Chronological aspects of ultrasonic, hormonal, and other indirect indices of ovulation

Ecochard R, Boehringer H, Rabilloud M, Marret H

Published August 21, 2001 BJOG : an International Journal of Obstetrics and Gynaecology, 108(8), 822-829

DOI 10.1111/j.1471-0528.2001.00194.x PMID 11510707

RRM Academy Synopsis

Mucus peak day tracks ovulation in 74% of normal cycles with a peak

This multicenter cohort followed 107 women with normal cycles through 326 cycles. Researchers checked each ovulation sign against ultrasound. Among cycles with a recorded mucus peak, the cervical mucus peak day fell within a day of ovulation in 74 out of 100 cycles. The luteinizing hormone peak did so in 68 out of 100.

Study at a glance, multicenter cohort: The mucus peak day fell within a day of ovulation in 74 out of 100 cycles — Study at a glance, multicenter cohort of 107 women with normal cycles: The mucus peak day fell within a day of ovulation in 74 out of 100 cycles. Source: Ecochard R et al., 2001, PMID 11510707.

Key Findings

Ultrasound confirmed the day of ovulation in 283 of 326 cycles (87%). The first scan came too late in 28 cycles (9%), and 15 other cycles had no ultrasound confirmation.
The luteinizing hormone peak fell from one day before to one day after ultrasound ovulation in 184 of 272 cycles (67.6%). It came more than one day later in 62 cycles (22.8%).
The cervical mucus peak symptom fell within one day of ultrasound ovulation in 160 of 215 cycles (74.4%). The luteinizing hormone initial rise did so in 201 of 273 cycles (73.6%).
The urinary estrogen-to-progesterone metabolite ratio was within one day in 194 of 272 cycles (72.8%). The basal body temperature rise was within one day in 30 of 277 cycles (10.8%).

Interpretation

The study is a multicenter cohort of 107 women aged 19 to 45 who already charted with natural family planning. Each result compares one ovulation sign with ultrasound. Women with fertility problems, polycystic ovary disease, luteal defects or frequent cycles without ovulation were excluded. The findings describe normal cycles only. The authors say the mucus peak and the luteinizing hormone initial rise might be better indices than the luteinizing hormone peak.

RRM Context

Fertility awareness methods use the cervical mucus peak symptom as a daily observation. The Creighton Model and the Billings Ovulation Method both anchor the fertile window to the mucus peak day. The basal body temperature rise often came more than two days after ovulation.

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

Abstract

Objective

To improve prediction of ovulation in normal cycles.

Design

Collection of women's characteristics and their menstrual cycles. Monitoring and analysis of time relationships between several indicators of ovulation: transvaginal ultrasonography, cervical mucus, basal body temperature, urinary luteinising hormone, and ratio of urinary oestrogen to progesterone metabolites.

Setting

Each of eight natural family planning clinics was to study 12 women for at least three cycles.

Population

One hundred and seven normally fertile and cycling women aged 18 to 45.

Methods

Daily measurements of urinary luteinising hormone, follicle stimulating hormone, oestrone-3-glucuronide and pregnanediol-3alpha-glucuronide. Basal body temperature recording and cervical mucus checking. Transvaginal ultrasound examination of the ovaries.

Main Outcome Measures

Delays between the expected day of ovulation according to the luteinising hormone peak or to ultrasound evidence and the expected days according to the other indices of ovulation.

Results

Ultrasonography was able to show evidence of ovulation in 283 out of 326 cycles. The average time lag between luteinising hormone peak and ultrasound evidence was less than one day (+0.46) but premature and late luteinising hormone-expected date of ovulation were observed in nearly 10% and 23% of cycles, respectively. Basal body temperature rise was observed in 98% of cycles. Cervical mucus peak symptom, rapid drop in the ratio of urinary metabolites, and luteinising hormone initial rise were all close to ultrasonographic evidence in more than 72% of cycles.

Conclusions

For accuracy and practical reasons, the cervical mucus peak symptom, the ratio of urinary metabolites and luteinising hormone initial rise might be better indices of ovulation than the luteinising hormone peak.

Topics

Menstrual Cycle › Cycle Biomarkers › Hormonal Markers · Fertility Awareness › Biomarkers › Urinary Hormone Monitoring · Reproductive Endocrinology › Ovulation Physiology › Follicular Development

René Ecochard, Hans Boehringer, Muriel Rabilloud, Henri Marret

R Ecochard, H Boehringer, M Rabilloud, H Marret

PMID 11510707 11510707 DOI 10.1111/j.1471-0528.2001.00194.x 10.1111/j.1471-0528.2001.00194.x Ecochard et al. 2001, Ecochard 2001

Keywords

Adult, Body Temperature/physiology, Cervix Mucus/physiology, Estrogens/urine, Female, Humans, Luteinizing Hormone/urine, Middle Aged, Ovary/diagnostic Imaging, Ovulation/physiology/urine, Time Factors, Ultrasonography, Estrogens, Luteinizing Hormone

Chronological aspects of ultrasonic, hormonal, and other indirect indices of ovulation

Mucus peak day tracks ovulation in 74% of normal cycles with a peak

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

Related research

Keywords