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

Abstract

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 Study participants 259 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 eleven previously defined algorithms that utilize estradiol, progesterone, and luteinizing hormone (LH) concentrations. Result(s) Algorithms based on serum LH, estradiol, and progesterone levels detected a prevalence of anovulation across the study period of 5.5% to 12.8% (concordant classification for 91.7% to 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 estradiol metabolite, estrone-3-glucuronide (E3G), 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 to luteal phase progesterone serum-based algorithms. Our study demonstrates that algorithms based on the LH surge, or in conjunction with E3G, potentially estimate a higher percentage of anovulatory episodes. Addition of measurements of post-ovulatory serum progesterone or urine pregnanediol may aid in detecting ovulation.

Dairy Food Intake Is Associated with Reproductive Hormones and Sporadic Anovulation among Healthy Premenopausal Women

“…The CV was <10% for estradiol and SHBG, <5% for LH and FSH, <14% for progesterone, and <7% for total testosterone. A sporadic anovulatory cycle was defined as a cycle with peak progesterone concentrations #5 ng/mL and no observed serum LH peak during the mid-or late luteal phase cycle visit (23). In total, 42 of the 509 cycles (8.3%) in the study were considered anovulatory.…”

Perceived Stress, Reproductive Hormones, and Ovulatory Function

“…17 Participants recorded menstrual bleeding via a daily diary. Menses length was defined as a bleeding episode that included ≥ 2 days of bleeding in a 3-day interval preceded by at least two bleed-free days 18 and total blood loss on each bleeding day was estimated using a standard algorithm.…”

Alcohol intake, reproductive hormones, and menstrual cycle function: a prospective cohort study

“…Because of limited frequency of binge drinking reported in the 24HDR, we were not able to assess the effect of binge drinking in our adjusted menstrual cycle-variable models. Sensitivity analyses were conducted with the use of a more-stringent cutoffs of ,3 ng/mL to define anovulation, ,10 d of luteal length, and ,10 ng luteal progesterone/mL to define luteal phase deficiency (LPD) and alternative cutoffs (on the basis of the distribution of our data) for long cycles ($35 vs. 26-35 d, $37 vs. 26-37 d, and $39 vs. 26-39 d) to test the robustness of our findings related to anovulation, LPD, and long cycles (36,37). All analyses were performed with SAS software (version 9.3; SAS Institute Inc.).…”

“…Long menses were defined as .7 d, and the total cycle blood flow was classified in tertiles as light (#36.5 mL), medium (.36.5 and #72.5 mL), or heavy (.72.5 mL). We defined anovulation as any cycle with a peak progesterone concentration ,5 ng/mL and no observed serum LH peak on the midluteal or late-luteal phase visits (n = 42 of 509 cycles; 8.3%) (37).…”