The Salivary Ferning Test and Ovulation in Clomiphene Citrate-Stimulated Cycles
Sumate Pattanasuttinont MD*, Wisan Sereepapong MD**, Somchai Suwajanakorn MD**
Affiliation : * Department of Obstetrics and Gynecology, HRH Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakornnayok ** Reproductive Medicine Unit, Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok
Objective : To determine the day of ovulation by the salivary ferning test in clomiphene citrate-treated women.
Design : A descriptive study.
Setting : Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok,
Thailand.
Subject : Seventy-five infertile women with regular menstrual cycles.
Materials and Methods : Infertile women were given 100 mg of clomiphene citrate for five days and collected
their saliva samples daily until seven days after ovulation. Transvaginal ultrasound was performed daily to
detect ovulation. The salivary ferning formation was examined by a normal light microscope and graded from
1-3, according to its extent and intensity.
Main outcome measure : The salivary ferning score, the peak salivary ferning day, and the day of ovulation
detected by ultrasound.
Results : The patients’ age and cycle length (mean + SD) were 32.9 + 3.7 years and 28.4 + 1.3 days. The peak
salivary ferning day corresponded with the ultrasound ovulation day in only 7.1%. There were two peaks of
median salivary ferning scores; one was two days prior ovulation and the other was five days post ovulation.
There was no correlation between the peak salivary ferning day and day of ovulation detected by ultrasound
(r = 0.102, p > 0.05).
Conclusion : In clomiphene citrate-stimulated cycles, the saliva ferning test does not seem to associate with
ovulation.
Keywords : Clomiphene citrate, Saliva, Ferning, Ovulation
