Morphological and hormonal changes during menstrual cycle

ABSTRACT

ovarian morphological changes were monitored by the use of the vaginal probe of a sector ultrasound in thirty five normally menstruating volunteers during 38 cycles. The results were correlated with changes in serum concentrations of oestradiol-17 [E2], progesterone [Prog.], FSH, LH and prolactin [Prl.]. Thirty one out of the 38 cycles studied [81.58%] were considered to fulfill the criteria of a normal ovulatory cycle. These cycles served to document the base-line for the population Assiut, Egypt. In these cycles, the mean-/+ SD follicular diameter increased form 11.17-/+0.68 mm on day [-4] to a maximum of 23.52-/+3.37 mm [range 18 to 23 mm] before ovulation, and subsequent luteal function was judged to be normal by normal progesterone production. Over the five days preceding ovulation and during the days [-1,0, and +1], follicular diameter was most closely correlated with serum E2 levels. The ultrasonographic evidence of ovulation never preceded the LH peak and the time of interval between the LH peak and ovulation which was within 24 hours in 93% [29/31] of the studied cycles. A significant rise in serum progesterone levels prior to or in the day of the LH peak, was demonstrated in ovulatory cycles indicating that luteinization of the dominant graafian follicle occurs prior to ovulation. Of the remaining seven cycles, three [8%] were conceptional cycles with ultrasonic and biochemical confirmation. The morphologic and hormone profile of these cycles did not differ from those of nonconceptional cycle. A chemical message indicating pregnancy was obtained as early as six days after ovulation by a rise of the serum concentration of either-hCG or Sp1. Two out of the seven cycles [5%] gave an ultrasonographic picture suggesting LUF syndrome. In these two cycles, no progesterone rise was observed over the period [-2 to +2]. Inadequate luteal phase was observed in one cycle [3%] which showed normal follicular growth but low progesterone level in the luteal phase. It can be concluded that ultrasonography and hormonal levels should be concurrently used in the detection of ovulation and characterization of the menstrual cycle in any programs of assisted conception