Folliculogenesis and ovulation during prolonged breast-feeding

This work aimed to determine the probability of ovulation and luteal phase adequacy during prolonged breast feeding. Frequent ultrasonographic ovarian scanning by the vaginal probe of a sector scanner to diagnose ovulation and measurement of serum progesterone seven days after the day of ovulation to assess adequacy of luteal phase. About 42% of the amenorrheic women showed ovarian quiescence, the rest had sonographic evidences of various types of ovarian activity. Ovulation followed by adequate luteal phase occurred in 8% of amenorrheic women [one of them resulted in pregnancy]. This incidence rose to 15 and 18% after resumption of menstruation. However, 73% of these ovulations were followed by evidence of luteal phase deficiency [LPD]. The women who showed ovulation followed by normal luteal phase gave less breast-feeds and more solid supplements than those who had quiescent ovaries. The differences in the infant feeding pattern was less marked between women showing other types of ovarian activity. Active breast feeding gave some protection from pregnancy after the sixth postpartum month with much less reliability than that found before that time. LPD is an important cause of infertility during prolonged breast feeding