| Infertility refers to the normal sex life, without contraception year's pregnancy, the incidence rate is 7% to 10%. The factors lead female infertility are anovulation, oviduct factors, uterus factors, cervical factors, which anovulation accounts for 25%~35%, hypothalamus - pituitary - ovarian dysfunction, ovarian diseases, adrenal and thyroid dysfunction mainly affect ovary function. Monitoring ovulation to seek causes and treatments of infertility is very important. To explore simple, accurate and practical methods of monitoring ovulation has always been the field of reproductive concerns. Currently monitoring ovulation methods have BBT, the examination of vaginal exfoliated cells, CM score, serum hormone determination, urinary LH determination and two-dimensional ultrasound examination, and so on. All of the above monitoring methods have advantages and disadvantages, so they are not individual to predict ovulation accurately.LH is the gonadotrophic hormone secreted by the pituitary gland, its physiological role is to promote the female ovulation and luteinizing, the LH peak is the reliable symbol which foretells ovulation soon. In clinical there are two ways to detect LH: One is serum LH, this method is quantitative detection and objectively by numerical comparison to judge the emergence of LH peak, high accuracy, is a reliable method to predict ovulation. But the detection needs extract the venous blood repeatedly and higher costs, the patient feels pain, the outcome is not immediately. Another is the determination of urinary LH, its numerical value is not influenced by the pituitary gland pulse secretion, the peak appearance and ovulation period's relations are stable. Urinary LH and serum LH has the very good relevance. Therefore urinary LH is accurate in predicting ovulation. Currently in clinical there are urinary LH qualitative and semi-quantitative detections. Semi-quantitative detection can reflect LH values changes before and after ovulation, it can more accurately predict ovulation time. Especially in the artificial insemination treatment technologies, selecting appropriate time to inject HCG directly affects the therapeutic efficacy. The method of semi-quantitative detection can choose the best time to inject HCG and determine artificial insemination. But the urinary LH test paper relies on the naked eye to observe the color of response line and judge the outcome, is quite subjective. It cannot intuitively reflect the follicular size, the growth situation, whether to ovulate and some ovarian pathological changes for example PCOS, OHSS. The two-dimensional ultrasound can make up for its shortcomings, directly observe the follicular morphology changes and whether to ovulate, the endometrial changes, and find the follicle dysplasia. Moreover in the promotion ovulation cycle the two-dimensional ultrasound can dynamically observe the ovarian changes, early detect the complications of the drugs, and has great significance. But this inspection requests high technical level, needs detect many times and spends more, because the individual mature follicle diameter's fluctuation scope is big, the follicular phase length is different.This article used the urinary LH test paper to detect urinary LH, and as the comparison extracted the vein blood to detect serum LH, to forecast ovulation date, transvaginal color doppler ultrasound affirmed whether to ovulate, and the development of follicle was normal or not. We monitored 86 natural ovulation cycles. The results showed that in the 86 cycles accuracy rate of positive result of urinary LH test paper predicted ovulation was 85.14%,71.43% ovulation occurred in 24h, 100% in 48h; Abnormal follicle growth rate was 16.28%, which LUFS incidence of 71.43%. In randomly selected 39 cycles from 86 cycles, positive result of urinary LH test paper predicted ovulation rate was 84.38%, peak of serum LH predicted ovulation rate was 86.49%, by the statistical analysis, the difference of accuracy rate in rate predicting ovulation was not statistically significant. Therefore the urinary LH test paper forecasts ovulation is rapid, the rate of accuracy is high, and the method is convenient, economic, noninvasive, combined with two-dimensional ultrasound examination can make up for its shortcomings, will be increased accuracy. At the same time ultrasound also found that abnormal development of the follicle was the important reason caused anovulation, in which LUFS was the high incidence. This paper was a qualitative detection of urinary LH, if using the semi-quantitative detection method, may be more accurately to predict ovulation time. According to this idea to do the further studies, we may find more accurate, simple method to predict ovulation. |
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