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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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