Depares, J., Ryder, R. E., Walker, S. M., Scanlon, M. F., & Norman, C. M. (1986). Ovarian ultrasonography highlights precision of symptoms of ovulation as markers of ovulation. British medical journal (Clinical research ed.), 292(6535), 1562. https://doi.org/10.1136/bmj.292.6535.1562
Depares J, Ryder RE, Walker SM, Scanlon MF, Norman CM. Ovarian ultrasonography highlights precision of symptoms of ovulation as markers of ovulation. Br Med J (Clin Res Ed). 1986;292(6535):1562. doi:10.1136/bmj.292.6535.1562
Depares, J., et al. "Ovarian ultrasonography highlights precision of symptoms of ovulation as markers of ovulation." British medical journal (Clinical research ed.), vol. 292, no. 6535, 1986, pp. 1562.
In recent years increasing interest has focused on the symptoms that accompany normal ovulation. 'Identifying the accuracy ofthese symptoms as indicators of ovulation is of practical importance both to the subfertile couple trying to maximise the chance of conception and to the couple using" natural fiaily planiing" to prevent conception. Until recently it has not been possible to assess the accuracy of the symptoms because of difficulties in assessing the exact time of ovulation. Ovarian ultrasonography has now been shown to allow accurate …
Pearson JT et al., 2021·Eur J Contracept Reprod Health Care·Free to read
Digital fertility awareness-based contraception offers an alternative choice for women who do not wish to use hormonal or invasive methods. The aim of this study was to investigate the key demographics of current users of the Natural Cycles app and assess the contraceptive outcomes of women preventing pregnancy in a UK cohort of women. This was a real world observational prospective observational study. The typical-use effectiveness of the method was calculated using both 13-cycle cumulative probability of pregnancy (life table analysis) and Pearl Index for the entire study cohort. Perfect-use PI was calculated using data from cycles where sexual intercourse during the fertile window was marked as protected and no unprotected sex was recorded on fertile days. 12,247 women were included in the study and contributed an average of 9.9 months of data for a total of 10,066 woman years of exposure. The mean age of the cohort was 30, mean BMI 23.4, the majority were in a stable relationship (83.2%) and had a university degree or higher (83%). The one year typical use, PI was 6.1 (95% CI: 5.6, 6.6) and with perfect-use was 2.0 (95% CI: 1.3, 2.8). 13 cycle pregnancy probability was 7.1%. This is the first study which describes the use of a digital contraceptive by women in the UK. It describes the demographics of users and how they correlate with the apps effectiveness at preventing pregnancy.
To improve prediction of ovulation in normal cycles. 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. Each of eight natural family planning clinics was to study 12 women for at least three cycles. One hundred and seven normally fertile and cycling women aged 18 to 45. 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. 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. 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. 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.
Indirect evidence of the occurrence of ovulation, which is generally accepted, is an increase in plasma or serum progesterone. Pelvic ultrasonography can estimate the probable time of ovulation within 12 h. There is a close association between the rise in progesterone, luteinizing hormone (LH) and oestrogen peaks and ovulation. A WHO study reported that ovulation occurred at a median time of 8 h after the rise in plasma progesterone, 15 h after the LH peak and 24 h after the oestrogen peak. The basal body temperature (BBT) method is the most effective in determining the premenstrual infertile period, but it is unreliable for an accurate determination of ovulation and the postmenstrual infertile period. Nor is BBT an effective method of predicting ovulation during postpartum lactational amenorrhoea. Therefore, BBT is usually used as a secondary indicator of ovulation and is combined with more reliable indicators. Observed changes in cervical mucus patterns can be used to define the probable fertile period, although this method produces a wide range of days. The peak mucus symptom is closely correlated with ovulation. Mucus symptoms can be used as a guide for the timing of blood or urine samples for estimation of LH, oestrogen and progesterone or their metabolites. Symptothermal methods incorporate other symptoms such as cervical changes, intermenstrual pain, breast tenderness and backaches, but these are secondary signs of ovulation and are recommended to be used in conjunction with mucus and BBT.
Several periovulatory symptoms sometimes used in natural family planning are correlated with the estimated time of ovulation in 23 subjects and 64 hormonally normal menstrual cycles. The data suggest that intermenstrual pain may not be due to 1 specific cause but rather to several related factors. As a symptom of ovulation, intermenstrual pain was more specific than lower backache, abdominal bloating, and intermenstrual bleeding nonetheless, intermenstrual pain has a broad periovulatory association. The most reproducible and predictable sign of this series appeared to be the postovulatory occurrence of breast tenderness.
Su HW et al., 2017·Bioengineering & translational medicine·Free full text on PubMed Central
The ability to identify the precise time of ovulation is important for women who want to plan conception or practice contraception. Here, we review the current literature on various methods for detecting ovulation including a review of point-of-care device technology. We incorporate an examination of methods to detect ovulation that have been developed and practiced for decades and analyze the indications and limitations of each-transvaginal ultrasonography, urinary luteinizing hormone detection, serum progesterone and urinary pregnanediol 3-glucuronide detection, urinary follicular stimulating hormone detection, basal body temperature monitoring, and cervical mucus and salivary ferning analysis. Some point-of-care ovulation detection devices have been developed and commercialized based on these methods, however previous research was limited by small sample size and an inconsistent standard reference to true ovulation.
PMID 3087519 3087519 DOI 10.1136/bmj.292.6535.1562 10.1136/bmj.292.6535.1562 Depares et al. 1986, Depares 1986
Cite this article
Depares, J., Ryder, R. E., Walker, S. M., Scanlon, M. F., & Norman, C. M. (1986). Ovarian ultrasonography highlights precision of symptoms of ovulation as markers of ovulation. British medical journal (Clinical research ed.), 292(6535), 1562. https://doi.org/10.1136/bmj.292.6535.1562
Depares J, Ryder RE, Walker SM, Scanlon MF, Norman CM. Ovarian ultrasonography highlights precision of symptoms of ovulation as markers of ovulation. Br Med J (Clin Res Ed). 1986;292(6535):1562. doi:10.1136/bmj.292.6535.1562
Depares, J., et al. "Ovarian ultrasonography highlights precision of symptoms of ovulation as markers of ovulation." British medical journal (Clinical research ed.), vol. 292, no. 6535, 1986, pp. 1562.
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