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Detection of Ovulation

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Preventive Powers of Ovulation and Progesterone
Detection of Ovulation by Dr. Jerilynn C. Prior, Scientific Director, Centre for Menstrual Cycle and Ovulation Research. I believe that ovulation with a normal luteal phase length – and normal amounts of progesterone to counterbalance and complement estrogen – is of key importance for women’s bone, breast and heart health (see Ovulatory Disturbances - They Do Matter [PDF]). In the last issue we discussed how you, personally, can tell that you are ovulating using the Molimina Question, recording and analyzing your basal temperature using quantitative methods (called QBT), and possibly using the over-the counter fertility test detecting the mid-cycle luteinizing hormone (LH) peak. We will now look at the medical methods for diagnosis of ovulation. How can a doctor tell if I am ovulating? For some physicians, especially those who specialize in fertility management, all methods for detecting ovulation (short of doing an operation and observing the egg actually squirting out of the ovary-see figure) are indirect and therefore considered inferior. There are three different, indirect medical methods that are commonly used to diagnose ovulation and normal progesterone action: 1) a series of ultrasounds of the ovary across the mid-cycle; 2) a biopsy of the uterine lining about a week after expected ovulation to see if the cells show evidence for progesterone action; and 3) taking one or several measurements of estrogen and progesterone in blood or urine to see if they show the expected ovulatory levels and pattern. We will discuss and critique each of these in turn. Note(for each of the following ovulation methods to be sensitive and specific, a woman must provide accurate information about the date of day one of her tested cycle and the date of the start of the next flow. Therefore, the start of the ovulation detection

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