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Assessment of anovulation in eumenorrheic women: comparison of ovulation detection algorithms

2014; Elsevier BV; Volume: 102; Issue: 2 Linguagem: Inglês

10.1016/j.fertnstert.2014.04.035

1556-5653

Kristine E. Lynch, Sunni L. Mumford, Karen C. Schliep, Brian W. Whitcomb, Shvetha M. Zarek, Anna Z. Pollack, Elizabeth R. Bertone‐Johnson, Michelle Danaher, Jean Wactawski‐Wende, Audrey J. Gaskins, Enrique F. Schisterman,

Pregnancy and preeclampsia studies

Objective To compare previously used algorithms to identify anovulatory menstrual cycles in women self-reporting regular menses. Design Prospective cohort study. Setting Western New York. Patient(s) Two hundred fifty-nine healthy, regularly menstruating women followed for one (n = 9) or two (n = 250) menstrual cycles (2005–2007). Intervention(s) None. Main Outcome Measure(s) Prevalence of sporadic anovulatory cycles identified using 11 previously defined algorithms that use E 2 , P, and LH concentrations. Result(s) Algorithms based on serum LH, E 2 , and P levels detected a prevalence of anovulation across the study period of 5.5%–12.8% (concordant classification for 91.7%–97.4% of cycles). The prevalence of anovulatory cycles varied from 3.4% to 18.6% using algorithms based on urinary LH alone or with the primary E 2 metabolite, estrone-3-glucuronide, levels. Conclusion(s) The prevalence of anovulatory cycles among healthy women varied by algorithm. Mid-cycle LH surge urine-based algorithms used in over-the-counter fertility monitors tended to classify a higher proportion of anovulatory cycles compared with luteal-phase P serum-based algorithms. Our study demonstrates that algorithms based on the LH surge, or in conjunction with estrone-3-glucuronide, potentially estimate a higher percentage of anovulatory episodes. Addition of measurements of postovulatory serum P or urine pregnanediol may aid in detecting ovulation.