We try to become pregnant half a year, while without rezultatno. I measure BT - in the first...

[Irina]

We try to become pregnant half a year, while without rezultatno. I measure BT - in the first phase 36.8 36 9, in the second 37.1 37.2. A cycle of regular 27 days. An ovulation for 14 day. In the last on\off cycles to the second phase saw Djufaston. Since 17 days the breast is strongly poured and hurts, and pulls a bottom of a stomach or belly. Today 2 DTS. The breast also hurts. The doctor has appointed or nominated to drink Mastadinon from 1 day of a cycle. Whether tell or say, please, can adjust reception Mastadinona a hormonal background and lead to depression BT in 1 phase and whether it is possible to combine reception Mastadinona and Djufastona. Thanks

[Kamenetskij B.A.]

Irina! I shall begin with the main thing. Half a year of absence of pregnancy it yet an occasion for trouble t. To.:
Sterility or Barrenness is defined or determined as disability to conceive at a regular sexual life without preservation within one year.
Pregnancy comes at healthy pairs at presence of a regular sexual life:
- In 3 months - 30 %
- In 7 months - 60 %
- In 12 months - 10 %
The regular sexual life - more than 2 times a month (on the CART) in okoloovuljatornyj perid is considered sufficient pregnancy for offensive or approach. To speak about any hormonal disturbances, it is necessary to execute, at least, researches on hormones. Now separately about mastodione. This preparation can be really appointed or nominated at disturbance of a menstrual cycle caused by a failure ljuteinovoj phases, and also for a cupping of signs premenstrual sindoma (in particular at a morbid strain of mammary glands). The combination mastodiona and djufastona is possible or probable. Separately about interpreting basal temperature. Almost daily I receive questions anyhow concerning or touching interpretings of data of basal (rectal) temperature. Below I would like to result or bring the small review of the literature, concerning or touching this research. Really, during decades this method was is unique accessible and the most used by the doctors who were deal with problems of fruitless marriage or spoilage. Not the secret, as now, despite of appreciable changes in diagnostics of endocrine disturbances, at availability of more modern and exact diagnostic opportunities, this method remains, strangely enough, dominating.
Basis of a method is the mediated influence of Progesteronum (the basic hormone of the second phase of a cycle) on thermoreceptors of a hypothalamus in this connection the basal temperature in the second phase of a menstrual cycle raises or increases. In 1888 And. Century Reprev has established or installed, that the body temperature before a menses raises or increases, and during monthly goes down. A.I.Rubel (1927) considered or counted, that the subfebrile condition at women can be an endocrine parentage and is in dependence from function of ovaries. In 1938 Rubinstein has described preovulatory depression of temperature which in its or his opinion, is caused estrogennym by influence. In 1950 Palmer eksperementalno has proved, that under influence of estrogens the rectal temperature decreases, and under influence of Progesteronum - raises or increases.
As if to itnterpretatsii these data and attempt to establish or install day of an ovulation by the majority of researchers it is recognized, that day of an ovulation coincides with day before the beginning of rise in temperature (. Item Majzel, 1965).
In domestic classical managements or manuals on gynecology of the last years it is described five basic types of temperature curves:
I type - rise in temperature in the second phase of a cycle not less than on 0, 4 With; there is a "preovulatory" and "premenstrual" temperature drop. Duration of rise in temperature of 12 14 days. Such curve is typical for a normal biphase menstrual cycle;
II type - is available weakly expressed rise of temperature (0, 2 0, 3) in the second phase. Such curve testifies about estrogen-progesteronovoj failures;
III type - temperature raises or increases shortly before a menses and there is no its or her "premenstrual" falling. The second phase is shorter than 10 days. Such curve is characteristic for a biphase menstrual cycle with a failure of the second phase;
IY type - a monotonous curve (there are no changes during all cycle). Such curve is marked or celebrated at anovulatory (the ovulation is absent) a cycle;
Y type - atipicheskaja (chaotic) temperature curve. Greater or big are marked or celebrated razmahi temperatures, does not keep within one of the above described types. Such type of a curve can be observed at expressed estrogennoj failures and as can depend on random factors (Century N.Kustarov, H.Pahk's Item, 1991).
Rising of basal temperature occurs or happens, as considers or counts series of authors (Moghissi K. S., Syner F. N., Evans T. N., 1972; Ross G. T., Cargille C. M., Lipsett M. B., Rayford P. L., Marshal J. R., Strott C. A., Rodbard D., 1970) when the level of Progesteronum in Serum of a blood exceeds 2, 5 4, 0 ng/ml (7, 6 12, 7 nmol/). However, the monophasic basal temperature has been revealed at of some patients with a normal level of Progesteronum in the second phase of a cycle (Johansson E. D. B., Larsson-Cohn U., Genizell G., 1970). Besides the monophasic basal temperature is noted, approximately, at 20 % of ovulatory cycles (Bauman J. E., 1981; Moghissi K. S., 1976). Simple ascertaining of biphase basal temperature does not prove also normal function of a yellow body (Bauman J. E., 1981). The basal temperature also cannot be applied to definition of time of offensive or approach of an ovulation as and at a luteinization neovulirovavshego a follicle the biphase basal temperature (Yoshimura Y., Tada S., Oda T., Nakamura Y., Maruyama K., Ishikawa F., Ebibara T., Hirota Y., 1989) is observed. Nevertheless duration ljuteinovoj phases according to data of basal temperature and low rate of rise of basal temperature after an ovulation are accepted by many authors (Isakova E., 1993, Downs K. A., Gibson M., 1983) as criteria of diagnostics of a syndrome of a luteinization neovulirujushchego a follicle. Series of factors, such as smoking, the intensive brainwork, the previous sexual certificate or act, non-observance of certain time of measurement of temperature can essentially change its or her parameters (Tachezy, 1959). Researches of last years evidently show, that correlation between changes of basal temperature and ovulatory changes in ovaries (confirmed by means of ultrasonic research) does not exceed 40 %.
This method can be used by women as the house test or dough at obviously known absence of a pathology of a menstrual cycle for planning pregnancy.
For definition of day of an ovulation by a method of a choice for today ultrasonic monitoring is. This method allows to receive the objective certificate on presence or absence of an ovulation.
Yours faithfully
B.Kamenetsky
The doctor akusher-the gynecologist, to. M. n.