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FERTILITY LIBRARY

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What is Ovulation

Ovulation is the process in the menstrual cycle by which a mature ovarian follicle ruptures and discharges an ovum (also known as an oocyte, female gamete, or casually, an egg) that participates in reproduction. Ovulation also occurs in the estrous cycle of other animals, which differs in many fundamental ways from the menstrual cycle. When the egg has nearly matured, the level of estradiol in the body has increased enough to trigger a sudden release of luteinizing hormone (LH) from the anterior pituitary gland. In the average cycle this LH surge starts around cycle day 12 and may last 48 hours. The release of LH matures the egg and weakens the wall of the follicle in the ovary, causing the fully developed follicle to release its secondary oocyte.The secondary oocyte promptly matures into an ootid and then becomes a mature ovum. The mature ovum has a diameter of about 0.2 mm.

Which of the two ovaries—left or right—ovulates appears essentially random; no known left/right co-ordination exists. Occasionally, both ovaries will release an egg; if both eggs are fertilized, the result is fraternal twins.

After being released from the ovary, the egg is swept into the fallopian tube by the fimbria, which is a fringe of tissue at the end of each fallopian tube. After about a day, an unfertilized egg will disintegrate or dissolve in the fallopian tube.

Fertilization by a spermatozoon, when it occurs, usually takes place well inside the fallopian tubes. A fertilized egg immediately begins the process of embryogenesis, or development. The developing embryo takes about three days to reach the uterus and another three days to implant into the endometrium. It has usually reached the blastocyst stage at the time of implantation.

In some women, ovulation features a characteristic pain called mittelschmerz (German term meaning middle pain) that may feel like abdominal cramps. The sudden change in hormones at the time of ovulation sometimes also causes light mid-cycle blood flow.

Fertile Window

The most fertile period (the time with the highest likelihood of pregnancy resulting from intercourse) covers the time from some 5 days before until 1–2 days after ovulation. In an average 28 day cycle with a 14-day luteal phase, this corresponds to the second and the beginning of the third week. However, few cycles are exactly average, and what was average for one woman in her early adulthood, may not be the same number once she matures further. A variety of methods have been developed to help individual women estimate the relatively fertile and the relatively infertile days in the cycle: these systems are called fertility awareness.

Fertility awareness methods that rely on cycle length records alone are called calendar-based methods. Methods that require observation of one or more of the three primary fertility signs (basal body temperature, cervical mucus, and cervical position) are known as symptoms-based methods. Urine test kits are available that detect the LH surge that occurs 24 to 36 hours before ovulation; these are known as ovulation predictor kits (OPKs). Computerized devices that interpret basal body temperatures, urinary test results, or changes in saliva are called fertility monitors.

A woman's fertility is also affected by her age. As a woman's total egg supply is formed in fetal life, to be ovulated decades later, it has been suggested that this long lifetime may make the chromatin of eggs more vulnerable to division problems, breakage, and mutation than the chromatin of sperm, which are produced continuously during a man's reproductive life.

History of Saliva Crystallization Test

1945:	Papanicolau first observed ferning (crystal formation) in dried cervical fluid
1969:	Dr. Biel Cassals, a Spanish gynecologist, studied the crystallization of saliva and concluded that the ferning of saliva is virtually identical in appearance to the arborization effect of cervical fluid.
1991:	M. Guida, Institute of Gynecology and Obstetrics Clinic in Napoli, Italy, study achieved a 92% positive result matching saliva ferning to the fertile preovulatory and ovulatory period.
1992:	M. Barbato, A. Pandolfi, M. Guida study found direct correlation between saliva ferning and the fertile period, stating that “salivary ferning may be used as a new parameter to aid women to detect the fertile period in combination with other symto-thermal methods of ovulation detection.”
1992:	2nd Department of Gynecology & Obstetrics in Brno, Czechoslavakia studied 300 women from an in vitro fertilization program who used a handheld microscope device to track saliva ferning and ovulation period. Results from the study determined a definite correlation between estrogen activity and the crystallization of saliva, classifying the reliability as “very high level”. When combined with the basil temperature method, a 99% reliability rate was claimed.
1994:	Clinical Center of Serbia conducted a study, “Determination of Fertile and Infertile Days of the Menstrual Cycle of Women by Using the Saliva Crystallization Test”, and found saliva ferning to be as effective as cervical mucus analysis and ultrasonographic folliculometry.
2001:	MaybeMOM, Inc. sponsors the first-ever U.S. clinical study in compliance with United States FDA requirements to test the effectiveness of its Mini Ovulation Microscope saliva fertility tester versus a urine-based ovulation tester. A 98% accuracy rate is achieved and the results are submitted to uphold their FDA 510(k).
2002:	FDA clearance to market the MaybeMOM Mini Ovulation Microscope in the United States is granted.