Re: NFP from pulpit..help with wording?

[Guest guest]

Len and ,The ClearBlue monitor used by and the Marquette method detects an E3G above baseline, and gives a variable amount of high days before the peak (see 's paper "Variability in the hormonally estimated fertile phase of the menstrual cycle." Fertil Steril 2008, p. 1234). Because women have different baseline E3G levels, the amount of days of "High" for each woman on the monitor could be different. ClearBlue will ask for tests every day from Day 6 to Day 25 or so.Persona uses a proprietary algorithm as Len was alluding to which is likely something similar to LH-5 to LH+3 based on the previous 6 cycles. The monitor asks for a test on Day 6, and then for 7 other tests in the cycle starting on Day 8 or later based on previous cycle parameters. Because it does not ask for daily tests, it cannot be used in a customized way like has proposed for the Marquette breastfeeding protocol.Certainly having accurate data with timed collections is helpful, but of course wider availability of Brown's monitor via Len's work is needed before we can see it implemented. Hopefully a future PDG test could be (A) home-based, ( practical (without requiring sending to a lab), © have high specificity for ovulation. This would be an excellent adjunct to all NFP methods.

Bouchard, MDFamily Medicine ResidentUniversity of Calgary

On 2012-05-02, at 7:52 PM, Len Blackwell wrote:

Dear ,

Thank you for your comments. Depending on your interest there are a

number of articles you could read. Also some of the material

Fehring and his team have published.

The Brown Monitor differs from the Persona Monitors in that we use timed

urine samples and measure both E1G and PdG. The first rise in E1G in a

prospective sense is the marker for the beginning of the fertile window

and the rise in PdG to exceed a thrreshold excretion rate to mark the end

of the fertile window. See our 1992 and 1998 papers). The Persona device

(and is more of an expert on this than I) is essentially a

sophisticated calendar device. It works on the principle that if we knew

when the LH peak was going to occur then we could define the fertile

window as LH-5 to LH + 4 (I think). By monitoring for 6 cycles the range

of LH peak days is determined and the algorithm constantly updates this

so that the beginning of testing is the earliest LH peak day -

5. E1G is measured as well and if this is elevated to lie

within one of two bands then fertility is signalled as having already

started and obviously the LH peak day was actually earlier than

predicted. The end of fertility is predicted from the LH peak day and not

definitively determined.

The Persona system uses early morning urine samples on the basis that the

urine volume is more constant overnight. However, the urine volume can

vary 10 fold from day to day.One of the barriers to widespread use of the

Monitor was the perception that collecting timed urine samples is too

difficult. However, the quality of the data is vastly improved by this

correction for urine volume and it is only because we do this that we can

measure the first rise in E1G above baseline levels.

I hope this helps and am ready to be corrected by !

Regards,

Len

At 12:40 a.m. 3/05/2012, rbamer2@... wrote:

Dear Len, thank you for your gracious reply. As someone who made it

through med school and residency within the last 15 years and never heard

a peep about NFP or the ability for women to monitor their cervical

mucus, BBTs or perform urinary hormonal testing, I for one am thankful

for you helping to disseminate Dr Browns findings, and for all the others

in this group who have made such great contributions to the field as

well.

I have read Types of ovarian activity in women and their significance:

the continuum and also A Study of Returning Fertility After Childbirth

and During Lactation by Measurement of Urinary Estrogen and Pregnanediol

Excretion and Cervical Mucus Production. Are there any other articles

which you feel we should read?

How does the Brown Monitor differ from the Clearblue or Persona

monitors?

If we want to convince medical professionals to learn about and offer NFP

in their practices, it would be good for all of us to study the hormonal

changes which create the readily observable fertile signs. This science,

if further developed and made readily understandable to physicians and

NFP Instructors alike, would unite all of the various NFP methods. One

could still teach most people, i.e., a variant of the ovulation method,

and it would suffice. But as the situation changes for the woman (the

continuum) or for the "forgotten women of NFP" there would be

other options. Of course, I realize that all of our methods have

attempted to adapt our rules for patients who have special circumstances

and the efficacy of these adaptations need to be further

studied.

I would look forward to a conference where your work would be summarized

or reviewed again for those of us who are just beginning this

journey.

Blessings to you and your work,

Dr Peck, MD, CCD, Marquette NFP Instructor

Sent via BlackBerry by AT & T

From: Len Blackwell <L.F.Blackwell@...>

Sender:

Date: Wed, 02 May 2012 17:48:08 +1200

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Reply

Subject: Fwd: Re: NFP from pulpit..help with

wording?

--- Re: NFP from pulpit..help with

wording?

Yes in principle.

With PdG a single value will give you the answer but with the BBT you

must have daily measurements and then if the BBT increase following a

mucus patch was small and lasted a single day it might be difficult to

interpret. However, I leave the BBT experts to discuss this.

Len Blackwell

On 1/05/2012 2:03 a.m., Kippley wrote:

Wouldn't the elevation or non-elevation of the basal temperature

after a mucus patch accomplish the same thing?

Kippley

<PdG.pdf><triggs.pdf>

[Guest guest]

I have heard an Indian company holds a patent on a urinary PDG test.M

Wouldn't the elevation or non-elevation of the basal temperature

after a mucus patch accomplish the same thing?

Kippley

<PdG.pdf><triggs.pdf>

[Guest guest]

Do you have any more  information?

Len

On 5/05/2012 1:41 p.m., Davenport wrote:

 

I have heard

an Indian company holds a patent on a urinary PDG

test.

M

 

Wouldn't the

elevation or

non-elevation of the

basal temperature

after a mucus patch

accomplish the same

thing?

Kippley

<PdG.pdf><triggs.pdf>