Functional diagnostic tests are a few simple methods that are used in gynecology to determine the functional state of a woman's reproductive system. Ovulation is the period of the menstrual cycle when the mature follicle leaves the ovary. Without ovulation, pregnancy is impossible. For many women who are faced with the problem of infertility, the cycle can be regular, timely and outwardly completely no different from the normal menstrual cycle. But at the same time, they do not ovulate, that is, the cycle is anovulatory. In modern gynecological practice, functional diagnostic tests are used specifically to find out if a woman is ovulating?
The "pupil" symptom is a way to control estrogen secretion
The "pupil" symptom is a simple method of functional diagnostics, which makes it possible to judge the production of estrogen hormones by the ovaries. A study is performed through a gynecological examination of the internal genital organs in the mirrors. In a normal biphasic menstrual cycle, starting on day 5 of the folliculin phase, estrogen secretion increases. From the same moment, the external opening of the cervical canal of the cervix begins to expand. The maximum expansion occurs at the time of ovulation, which is influenced by the peak concentration of estrogens. After ovulation, estrogen secretion decreases and the opening of the cervical canal closes. Visually, during a gynecological examination in the mirrors, the open cervical canal resembles a human "pupil". According to the degree of expansion of the external os of the cervical canal, one can roughly judge whether
The symptom of cervical mucus distension indicates the onset of ovulation
Another method of functional diagnostics associated with cervical mucus. When a smear of cervical mucus is exposed to air, it tends to crystallize, forming a certain pattern on a glass slide, similar to a fern leaf. The intensity of crystallization directly depends on the concentration of estrogens. After drying the smear of mucus, the slide is examined under a microscope. If the mucus is visualized as separate fern stalks, the secretion of estrogen in the body is minimal, that is, the woman is in the early folliculin phase of the menstrual cycle. The rich pattern of the fern leaf indicates moderate estrogen secretion and the middle follicular phase. At the time of ovulation, crystallization will be maximum, under a microscope you can see thick fern stalks and clear leaves, extending from them at right angles. The absence of a picture, in turn, will indicate an estrogen deficiency in the body.
Karyopycnotic index - an informative method of functional diagnostics
Karyopycnotic index (KPI) is the ratio of keratinizing and intermediate cells of the vaginal epithelium. Karyopyknosis is the process of maturation of epithelial cells, during which the cell nucleus decreases in size, and the cell itself seems to shrink. This process also occurs under estrogenic influence, and cells that have undergone the process of karyopyknosis are called pycnotic. When examining a smear taken from the posterior fornix of the vagina under a microscope, the ratio of pyknotic cells to those cells that have not undergone the process of karyopyknosis is calculated. In the first phase of the menstrual cycle, the CPI is 25-30%, at the time of ovulation, the ratio reaches 60-80%, and in the luteal phase, the CPI again decreases to 25-30%.
Basal temperature measurement will help determine ovulation
Measurement of basal temperature is the simplest and most accessible method of functional diagnostics that allows you to determine the onset of ovulation. Daily measurement of basal temperature for several months should be recommended to all women who turn to a gynecologist with complaints of infertility. In the follicular phase, the basal temperature is in the range of 36.3 ° C-36.8 ° C. On the day of ovulation, the basal temperature rises sharply above 37 ° C, and until the end of the luteal phase it is in the range of 37 ° C - 38 ° C. These changes are depicted in the form of a temperature curve, with which you can easily determine whether the woman's menstrual cycle is ovulatory. During anovulation, the temperature curve remains monophasic, without sudden temperature jumps.
Functional diagnostic tests should be assessed in aggregate
Methods of functional diagnostics are a simple and universal way to determine the state of the female reproductive system. But it must be remembered that they must be evaluated in aggregate and over several cycles - then it will be possible to obtain the most reliable information about the menstrual cycle, estrogen secretion and the onset of ovulation. The most accurate method for assessing ovarian function is a histological examination of an endometrial scraping, which indicates with an accuracy of 90% whether a woman is ovulating.
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