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Ultrasound of ovaries and
uterus
(Prelevic G.M., 1992)
Ultrasound of
ovary and uterus are irreplaceable methods
for evaluation of ovulation in clinical
practice. This is a reliable method for the
establishment of the size and morphology of
ovaries and uterus, dynamics of the follicle
development as well as changes in
endometrium quantitative and qualitative
terms both in spontaneous and stimulated
cycles.
Transabdominal
and transvaginal methods may be used.
Ovary follicles
20-25 mm in size with the appearance of “
double contour” and the echo of cumulus
oophorus are considered to be the sign of
the forthcoming ovulation. The
ultrasonographic sign of the ovulation is
considered to be the disappearance of the
ovary follicle with the appearance of a new
sign on endometrium, the so-called
ovulation ring.
However, this
method is not simple in the least and
requires the most modern ultrasound devices,
great experience and expertise of doctors as
well as daily clinic attendance of the woman
in periovulatory period.
Clinical
investigation covered by this paper is a
prospective study carried out at the Clinic
of Gynaecology and Obstretics “Narodni
Front” in Belgrade, Sterility Department,
under the professional guidance of Assistant
Professor dr Ratomir Ganovic, the head of
the department, and associates.
The preliminary
name of the test, “LADY TEST”, borrowed from
foreign literature, was later replaced by
“GANOP TEST” after the name of its authors
and the Clinic.
Purpose of the project
The following
objectives have been specified in the course
of investigation:
1. Evaluation of the utility
and clinical value of GANOP test of saliva
in determination of fertile and infertile
days in menstrual cycle.
2. Determination of
approximate time of ovulation in patients
under observation by using FERN test -
analysis of cervical mucus.
3. Ultrasonographic
monitoring of the dynamics of the follicle
growth and development as well as changes in
thickness and structure of endometrium
throughout the menstrual cycle confirming
at the same time the occurrence of
ovulation.
4. Compare results of the
FERN test and GANOP test with the results of
ultrasonographic folliculometry.
5. Compare the results
obtained with the ones of other researchers.
A special
objective was to determine validity,
sensitivity, specificity and diagnostic
doctrine of GANOP test as a saliva
crystallization test i.e. a test for
determination of fertile and infertile days
in the menstrual cycle.
Material and methods
The investigation
covered 71 woman of generative age. Out of
71 patients,
those with non stimulated
cycle accounted for 81.69% (58), while in
11.27% (8) patients the cycle was stimulated
by Clomifen Citrate and, in 7.04%cases (5),
the stimulation was carried out by Clomifen
citrate and Human menopausal gonadotropin in
combination.
The tests were
conducted from the 8th to 20th day of the
cycle. A total number of the examinations
performed was 213. Every patient was
examined at 3 different points of time and
each time the following was carried out:
-
ultrasonographic folliculometry and
sonoendometry (apparatus ALOKA SSD620,
transvaginal probe 5mhz)
- Test of
crystallization of cervical mucus - FERN
test (microscope ZEISS)
- Test of
crystallization of saliva - GANOP test (minimicroscope
MAYBE BABY with enlargement 52 times,
product of “OPTIX”, Belgrade).
All three
examinations were carried out quite
separately and the results for every patient
were entered into forms specially devised
for this research.
For evaluation
purposes, results of ultrasonographic
folliculometry were recorded in terms of the
size of follicle in millimeters or “ovulatio”;
the results of FERN and GANOP tests were
marked by (0), (+), (++),(+++), depending on
the quantity of “fern” in the dried sample
of cervical mucus or saliva.
During the
research, microscopic shots were taken of
FERN and GANOP tests samples. Characteristic
photographs are attached to this paper.
The obtained
results were statistically processed by
chi-square test, analysis of variance and
analysis of correlation ( Pearson and
Spearman correlation)
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