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Fertility Disorders and the Billings Ovulation Method
Dr. Pilar Vigil P. Faculty of Biological Sciences Pontifical
Catholic University of Chile |
This paper was presented at the International Jubilee Conference,
50th Anniversary of Billings Method, UNiversity of Melbourne, Australia,
conducted by Ovulation Method Research & Reference Centre of
Australia, March 28-30, 2003.
Printable version of these pages in PDF format
Contents
Introduction
Fertility is a transient biological state that depends on the fertility
potential of the couple. During a women’s lifetime, the ovary
will go through different states of hormonal secretion and ovulation.
The concept of the ovarian cycle as a continuum considers that all
types of ovarian activity encountered during the reproductive life
are normal responses to different environmental conditions in order
to ensure the health of the mother and child.
During the first two years after menarche, occasional anovulatory
cycles may occur. However, subsequently, a healthy ovary will exhibit
regular monthly ovulations, characterized by a 25 to 36 day cycle
(32, 33, and 35). The ovulatory cycles are normally only interrupted
by pregnancies and breastfeeding. Normal ovulatory activity and
fertility are restored following pregnancy and breast feeding, however,
stress or excessive exercise may result in a chronic ovulatory dysfunction
that requires therapy. Anovulatory cycles frequently occur as menopause
approaches. This is an expected part of woman’s reproductive
life cycle.
The use of the ovarian monitor has made it
possible to identify hormonal variations during different
periods of a woman’s life and to correlate these changes
with the mucus patterns (5, 6, 7). Thousands of measurements
have been recorded for this purpose around the world, including
Chile. These investigations have raised an enormous amount
of information (24, 24). The amount and type of mucus secreted
by the cervix changes through the ovarian cycle in response
to fluctuating hormonal levels (26, 30 and 31). Mucins are
the main components of mucus (18). To date a total of 13 distinct
mucin genes have been identified (11,18). Mucins are categorized
into 3 groups on the basis of their structural properties:
membrane spanning (MUCs 1, 3, 4, 12 and 13, gel forming (MUCs
2, 5AC, 5B and 6) and small soluble (MUC 7). The four large
gel-forming mucin genes are located on chromosome 11.p15.5
(12,18). Mucin 5B is the major gel forming mucin expressed
by the endocervical epithelium and its expression peaks at
midcycle (10). Message levels for mucin 4 also peak at midcycle.
Two main types of cervical mucus have been described: oestrogenic
and progestative. According to O’deblad’s model,
the oestrogenic type can be subdivided in L, S and P subtypes
(4). The L subtype is the most abundant type of mucus during
the periovulatory period and the P subtype appears close to
ovulation (8). Message for all mucins diminishes as progesterone
levels increase in blood. (11) During the luteal phase the
progestative type of mucus is present. |
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Estrogenic types of mucus: EP, ES, EL |
G mucus, stimulated by Progesterone |
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