By Richard A. Donald
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Renaud RL, Maclear J, Dervan I, Ahret M, Aron Plas-Rosert S, Spida A, Pollack H. Echographic study of follicular maturation and ovulation during the normal menstrual cycle. Fertil Steril 1980; 33:272-276. 4. Sims JM. Clinical Notes on Uterine Surgery with Special Reference to the Management of the Sterile Condition. Robert Hardwicke, London, 1866. 5. Hühner M. Sterility in the Male and Female and Its Treatment. Rebman, New York, 1913. 6. Sobrero AJ, MacLeod J. The immediate post coital test. Fertil Steril 1962;13:184-189.
However, fundus photography, in conjunction with fluorescein angiography, is of great use prior to applying laser treatment for diabetic retinopathy, a condition that can accompany some endocrine disorders (5). 42 / Suckling B. Optic Atrophy It is normal to have some temporal pallor, especially if the physiological cup is large. One should strongly suspect atrophy when the nasal side of the disk shows pallor, and at a later stage when few if any bands of ganglion cell axons are seen. Disk atrophy in chiasmal lesions tends to be horizontal, while in tract lesions it is horizontal on the opposite side, but vertical on the same side.
The cervix should be exposed with the speculum and the amount of mucus visible at the external os, as well as the degree of cervical opening is noted. A specimen of mucus is obtained either with a cotton wool swab or an inoculation loop. The mucus is placed on a microscope slide, and stretched so that the spinnbarkeit can be measured and graded. The mucus is then spread along the slide and allowed to dry. It is examined under a microscope on low power and the degree of ferning is quantitated. The scoring system is described in Table 1.