[Ascites, hydrothorax and ovarian tumor: Meigs' syndrome in a patient with small ovaries and increased CA 125 level]. / Ascites, hydrothorax en ovariumtumor: syndroom van Meigs, bij een patiënte met kleine ovaria en gestegen CA 125-waarde.

In a 51-year-old woman with bilateral Brenner tumours of the ovaries and with intermittent hydrothorax and ascites, Meigs' syndrome was diagnosed. The serum CA 125 level was 620 U/ml (normal: 5-35). Bilateral ovariectomy, hysterectomy and omentectomy were carried out. The ovaries were not enlarged. Postoperatively, the pleural effusion and ascites resolved and the CA 125 level decreased to 8.4 U/ml. The pathogenesis of hydrothorax probably involves passage through the diaphragm, and the CA 125 may be produced by the peritoneal lining or by the Brenner tumours.

Follicle growth curves and hormonal patterns in patients with the luteinized unruptured follicle syndrome.

A prospective longitudinal and standardized study is presented, dealing with ultrasonographic and hormonal characteristics of the luteinized unruptured follicle (LUF) syndrome. Among 600 cycles monitored in 270 infertility patients, 40 cycles in 27 patients showed no evidence of follicle rupture, in spite of signs of luteinization, as reflected by basal body temperature recordings and progesterone determinations. In this study, 20 LUF cycles in 20 infertile patients were compared with 45 ovulatory cycles in 45 control women. During the follicular phase, no substantial difference in follicle growth was found, but after the luteinizing hormone peak, LUF follicles, instead of rupturing, showed a typical accelerated growth pattern. Both mean luteinizing hormone peak levels and midluteal progesterone levels were significantly lower in LUF cycles than in the control cycles. However, the duration of the luteal phase was not affected. Both central and local factors can be held responsible for the lack of follicle rupture. Ultrasound offers new possibilities as a noninvasive method in diagnosing the LUF syndrome.

Relation between ultrasonographic evidence of ovulation and hormonal parameters: luteinizing hormone surge and initial progesterone rise.

Relations between ultrasonographic signs of ovulation, the luteinizing hormone (LH) surge, and progesterone rise were documented in 28 and 24 spontaneous ovulations, respectively. Two definitions for LH surge were applied to a series of daily LH determinations. The first LH rise was recorded 48 to 11 hours before ultrasonographic signs of ovulation. The best estimate of the LH peak preceded ovulation by 24 to 11 hours, two extremes excluded. The mean progesterone values during the observed ovulation period were in agreement with data in the literature concerning ovulation period were in agreement with data in the literature concerning ovulation timing by corpus luteum histologic features. A considerable intercycle variation is reported in progesterone level and in the slope of the progesterone increase around ovulation. It is concluded that ultrasonographic signs of ovulation might be closely related to anatomic ovulation.

Basal body temperature as a method of ovulation detection: comparison with ultrasonographical findings.

In 47 cycles with hormonal evidence of ovulation, the detection and timing of ovulation by basal body temperature (BBT) and by ultrasonographical observation are compared. The ovulation detection rate by ultrasonographical method proves to be considerably higher than by BBT criteria. The timing of the day of ovulation is evaluated, assuming that the ultrasonographical event of follicle disappearance represents ovulation. BBT criteria nadir, coverline and the eye-balling method show a very poor frequency distribution. The result of the FDHP method is a nearly symmetrical distribution, however, with a considerable range. We conclude that ovulation detection and timing by BBT are not reliable.