Normally there is variation of temperature of body during menstruation. Following ovulation (24 hours after ovulation) there is mild elevation of body temperature (0.5 C0 – 1 C0) due to thermogenic effect of progesterone. Raised temperature is sustained throughout the second half of the cycle and fall 2-3 days prior to next cycle. In addition to that there is slight fall in temperature at the ovulation but it is difficult to detect.
Body temperature measures from the day one of the menstrual cycle by ideally using fertility thermometer and chart it. women should measure her oral temperature each day morning after getting up form bed without washing mouth or having tea ect… . if there is raised temperature in second half of the cycle, ovulation has occurred .
Measurement of progesterone level (Hormonal method )
Serum progesterone level performed approximately seven days
before the predicted date of a menstrual period (day 1). If women has 28 days cycle,
test performed on day 21.elevated level of progesterone (above 20-25nmol)
confirms ovulation occurred in that cycle
Cervical mucus stretch test (
Spinnbarkeit test )
The cervical mucus is produced by the cervix and changes consistency throughout menstrual cycle under influence of estrogen and progesterone.estrogen makes the mucus thinner and more alkaline.under influence of progestarone cervical mucus become thick,tenacious and more cellular. at the time of ovulation cervical mucus are thinnest and it elasticity increase ( spinnbarkeit ). therefor when strech drop of cervical mucus it can be stretch into long
Disappearance of fern pattern of cervial mucus also aused to determine ovulation
4.Explain the physiological basis for the use of oral combined contraceptive pill
During normal menstrual cycle hypothalamus secretes GnRH and stimulate pituitary to secrete FSH and LH .FSH act on ovary and cause maturation of follicle. These follicles secrete estrogen which act on hypothalamus and pituitary and inhibit release of GnRH and FSH and LH (negative feedback mechanism). At about 14 day of cycle ,due to LH surge ovulation occur . Following ovulation, corpus luteum produced progesterone and maintain secretory phase of endometrium .These progesterone act on hypothalamus inhibit it ( negative feedback Mechanism ) .
Oral combine contraceptive pill contain high level of estrogen and progesterone. This hormone act on hypothalamus and decreases the pulse frequency of GnRH. Therefore decreases the release of FSH and LH . Decrease level of FSH inhibit development of follicle and absence of LH surge result anovulation . Secretory phase of endometrium is maintained by progesterone which is in the oral contraceptive in the absence of corpus luteum . After 21 days menstruation occur due to absence of hormonal pill. After 21 days pill contain iron which gives iron which is lost during menstruation