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The Muasher Center
for Fertility and IVF
8501 Arlington Boulevard, Suite 500
Fairfax, Virginia 22031

Ph. 703.876.6311
Fx. 703.876.6317

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Dr. Muasher uses several tests to assess ovulation and the basal body temperature chart, urinary LH test kit, progesterone measurements, and ultrasound are discussed here.

Basal Body Temperature Charts (BBT)

Monitoring the basal body temperature (BBT) is useful for predicting ovulation and timing intercourse. The body temperature small changes in temperature and can be purchased at most pharmacies.

A woman's body temperature varies throughout the menstrual cycle and rises slightly (0.5 degree F) immediately after ovulation in association with an increase in the hormone progesterone.

A BBT chart is created by tracking temperature changes for several months to determine the "ovulatory pattern". Ovulation occurs at approximately the same time each month so it is possible to predict the best days for intercourse based upon the charts. The major disadvantages of BBT charting are that the temperature must be taken daily and it is less accurate than urinary hormone measurements.

Luteinizing Hormone Monitoring Kits (Urinary LH Kits)

There is an increase in luteinizing hormone immediately prior to ovulation. Once the follicles mature, the hypothalamus signals the pituitary to release large amounts of LH to stimulate ovulation, which occurs within 36 hours. Ovulation predictor kits measure the LH level and indicate in advance when the egg will most likely be released. Intercourse is planned around the most fertile times. These kits are more accurate than BBT charting; however, they are more expensive.

Progesterone

Progesterone is produced by the corpus luteum, which is the structure formed by the follicle after ovulation. After a pregnancy has been established, progesterone is produced by the placenta. Levels of progesterone rise after successful ovulation and this hormone functions to prepare the endometrium to thicken and become more vascular to accept the developing embryo. Low levels of progesterone may indicate that ovulation did not occur or it could signal that a "luteal phase defect" is present.

Endometrial Biopsy

The endometrial biopsy is used to determine if the endometrium is thickening properly during the menstrual cycle under the influence of the hormone progesterone. During the luteal phase of the menstrual cycle, the corpus luteum (structure formed by the follicle after ovulation) begins to secrete progesterone. Progesterone stimulates the endometrium to thicken and increase its blood supply in preparation to support a developing embryo.

The endometrial biopsy is taken approximately twelve days after ovulation, and before menstruation, by inserting a small catheter into the uterus and removing a small sample of the uterine lining (endometrium). The cells are examined under a microscope to determine if they are at the proper stage of development. If they are not, the condition may be termed a "luteal phase defect".

Progesterone is often administered to provide additional luteal phase support and stimulate endometrial development.

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