Ovulation prediction and detection in spontaneous and stimulated cycles

The accuracy of various methods in predicting and detecting ovulation is evaluated in 24 ladies: 10 with spontaneous and 14 with clomiphene citrate [CC] induced cycles. Starting at day 8 of the cycle, all subjects were followed with: daily transvaginal ultrasound [TV-US], rapid radioimmunossay [RIA] measurement of both serum luteinizing hormone [LH] and estradiol [E2], determination of urinary LH with Fluoroimmunoassay [FIA] together with recording of basal body temperature [BBT]. Progesterone in serum was measured 7 days after ovulation detection. The mean follicular diameter [MFD] of the pre-ovulatory follicle was significantly larger in CC-stimulated cycles than in spontaneous cycles [29.2 +/- 1.1 mm versus versus 21.8 +/- 0.5 mm; P 0.001]. Post-ovulatory serum progesterone was higher in CC cycles [35.2 +/- 3.9 ng/ml] than in spontaneous cycles [18.5 +/- 2.1 ng/ml] significantly [P 0.005]. Mean daily serum LH levels were similar in both groups. Peak values of 40 mIU/ml or greater preceded the day of ovulation as detected by sonography in all cycles. Serum E2 peak was significantly greater in CC-cycles than in spontaneous ones [950 +/- 40 and 450 +/- 22 pg/ml respectively, P 0.01] in 96% of the cycles. BBT nadir predicted the day of ovulation in only 12% of cycles in all cases. LH surge in urine was pronounced after serum LH peak in blood: 85% one day after [i.e. at the day of ovulation] and 15% 2 days after [almost similar in both groups]. TV-US is revealed to be an excellent method for detection and timing of ovulation and FIA of urinary LH is a very useful method for prediction of the day of ovulation

Post-myocardial infarction sexual dysfunction

Sexuality in the post-cardiac infarction patient is an important, poorly approached area. For 43 non-diabetic, non-hypertensive patients with post- myocardial infarction sexual dysfunction; the erectile function [as measured by direct interrogation and specific questions], sex hormonal profile [radioimmunoassay], cardiac function [New York Heart association Classification], echocardiography and psychological status [as measured by standard tests] were evaluated. Patients mean age was 48.5 years [31- 65 range] and they suffered impotence for at least months. There was inconcordance between the degrees of cardiac dysfunction, sexual dysfunctions and sex hormonal changes. Psychologically, patients showed mostly two maladaptive coping styles; the denier and the cardiac invalid [myths about sudden death during intercourse]; 48% of patients were anxious and depressed. It was concluded that postmyocardial infarction sexual dysfunction is a multifaceted problem. In addition to the involvement of the penile arteries by the atherosclerotic process, the psychological status tops the list of causes which included medications, cardiac dysfunction and others. The communication gap between the patient and his physician who is embarrassed or unknowledgeable about the subject needs to be shunted. Patients should be advised as to the realities of their fears and provided with guidelines for facilitating a satisfying sexual relationship

Serum gonadotropins, testosterone and prolactin in azoospermic men in relation to the histopathological changes

Serum follicle stimulating hormone [FSH], luteinizing hormone [LH], testosterone and prolactin levels in relation to histopathological appearance were studied in 32 azoospermic men. Histologically, they were classified into four groups; normal[25%], sertoli-cell-only syndrome [28.1%], maturation arrest [25%] and focal tubular atrophy [21.8%]. In azoospermic men with normal histological findings, gonadotropins and testosterone levels were within the normal values. In other groups associated with histological changes, gonadotropins were significantly raised. Testosterone had a significant lower levels than normal in cases of maturation arrest. Prolactin levels were normal in all azoospermic men. These findings suggested the importance of hormonal determination for evaluation and management of male infertility

Progesterone and estradiol in saliva and plasma during the menstrual cycle-relation and application

Plasma and salivary progesterone and estradiol were measured throughout the menstrual cycles of 10 women, and before and after intramuscular injection of progesterone in 4 women. Mean +/- standard error [SE] of salivary progesterone increased significantly from 216.1 +/- 12.6 pg/ml in the proliferative phase to 464.3 +/- 28.7 pg/ml in the secretory phase [P < 0.001]. There was a highly significant correlation between plasma and salivary progesterone levels throughout the menstrual cycle [r equal 0.6588 and P < 0.001]. The ratio of plasma: salivary progesterone was 9.63 during the proliferative phase and increased to 29.8 during the secretory phase. After the intramuscular injection of progesterone, both plasma and salivary progesterone increased in a dose-dependent manner, with peak levels attained 2-3 hours after the injection. Salivary estradiol levels increased from 5 to 18 and from 8 to 35 pg/ml in the proliferative and secretory phases respectively, but no correlation with plasma estradiol levels was noted. The findings are discussed in relationship to the origin of salivary progesterone and its potential use as an index of ovulation and for estimating luteal function. Also, these findings indicate that the salivary progesterone provides a reliable and noninvasive method which may replace serum measurements for monitoring stimulated cycles in an IVF-ET program