-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: anovulatory cycles From: Elrod Darryl G MAJ 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL) Wed Nov 10 06:04:21 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Douglas Krell: "Re: NYTimes.com Article: Commentary: Defining a Doctor, With" Previous message: Marie Harkins: "Re: anovulatory cycles" Maybe in reply to: Jennifer Grossman, D.O.: "anovulatory cycles" Next in thread: Henry Gregor: "re Steve and Eryl Raymond" Reply: Henry Gregor: "re Steve and Eryl Raymond" You can assume that someone is ovulating from an ultrasound. If you look at the endometrium from the early follicular phase into the early secretory phase you can see a trilaminar pattern and in the secretory phase it becomes homogeneous. (Hofmann G et al, High-Resolution endovaginal ultrasonography of the endometrium Obstet Gynecol 1991;78:200-204 It is not absolute proof that they are ovulating, but along with a corpus luteum is good evidence. As for clomid, you have to remember its effects on cervical mucous when giving it. Glen D. Glen Elrod, Maj USAF, MC Obstetrician/Gynecologist Maternal Child Flight 48 MDOS/SGOBO UNIT 5210 Box 23 APO, AE 09464 DSN (314) 226-8334 Comm 01638-52-8334 Notice of Confidentiality Under the Privacy Act of 1974, you must safeguard all information reflected on this Email and, if applicable, all attachments. Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI 37-132, AFI 33-219, and PL 93-579" This document may contain information covered under the Privacy Act, 5 USC 552(a), and/or the Health Insurance Portability and Accountability Act (PL 104-191) and its various implementing regulations and must be protected in accordance with those provisions. Healthcare information is personal and sensitive and must be treated accordingly. See <https://sg.usafe.af.mil/HIPAADisclosure.cfm> for full details. -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Steve & Eryl Raymond Sent: Wednesday, November 10, 2004 11:15 AM To: Multiple recipients of list OB-GYN-L Subject: Re: anovulatory cycles 1.Where do you get the idea from that you can tell if someone is ovulating from an ultrasound? There are only two ways to be sure of ovulation - one is to show a sustained rise in serum progesterone in the luteal phase, the other is to show secretory changes in the endometrium. 2.What percentage of women, ovulatory or anovulatory, show a rise in testosterone without symptoms? Estimating a testosterone level would be one of the least useful tests you could do for anovulatory cycles. 3. What percentage of anovulatory women are proving to have insulin resistance? Before doing something as expensive as an insulin resistance test how about something as cheap and reliable as a Glucose tolerance Test. 4. The prescription of Clomiphene Citrate should never be "take this it might enhance your ovulation". If the normally ovulating patient takes it, it may in fact reduce ovulation chances. It should not be prescribed unless there is proof of anovulation or of a poor luteal phase. 5. If the LH stick remains negative then it means without doubt that she has not ovulated and confirmatory tests for the luteal phase need to be done. If you are unsure of these basic reproductive endocrinology/infertility processes I suggest you send her to someone with the necessary skill and knowledge. Judith Cerdà Belmonte wrote: >I would make >-hormonal tests (testosterone, LH, etc) >-insulin resistant test >-and a following up with ultrasounds for one cycle. > >The u/s will tell you if she is ovulating and check how healthy are her >ovaries (any cysts?). The hormonal tests will be able to detect disorders >such as the policystic ovarian syndrome (PCOS). Moreover, many Americans >have diabetes type II which does not allow you sometimes to ovulate. Take >care about the testosterone results: if she is exercicing very hard (more >than 1 hour per day), tell her to do relax little. > >Maybe in the future she should take CC (Clomiphene Citrate) to enhance >ovulation is she is TTC. But you need some tests and u/s results before >you take any decission. > >I hope this helps. > >Judith C Belmonte, PhD > >Jennifer Grossman, D.O. va dir: > >>how common is it for women in their 30's to have anovulatory cycles? i >>have a patient who has been taking basal temps, and using a fertility >>monitor for months...it appears that the temps follow a pattern up to a >>point, dropping down at the time of supposed ovulation - but then the LH >>sticks read negative. >>menses still occur, although somewhat irregularly. >>how influential can exercise be at this time in life? does it have to be >>daily, heavy exercise to cause anovulation? what can i tell her about >>what to expect in future months? >> > Next message: Douglas Krell: "Re: NYTimes.com Article: Commentary: Defining a Doctor, With" Previous message: Marie Harkins: "Re: anovulatory cycles" Maybe in reply to: Jennifer Grossman, D.O.: "anovulatory cycles" Next in thread: Henry Gregor: "re Steve and Eryl Raymond" Reply: Henry Gregor: "re Steve and Eryl Raymond"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Tue Sep 2 05:02:07 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.