Monitoring of ovarian activity by measurement of urinary excretion rates using the Ovarian Monitor, Part IV: the relationship of the pregnanediol glucuronide threshold to basal body temperature and cervical mucus as markers for the beginning of the post-ovulatory infertile period

Blackwell, Leonard F.; Vigil, Pilar; Alliende, Marı́a Elena; Brown, Simon; Festin, Mario; Cooke, Delwyn G.

doi:10.1093/humrep/dev303

Cited by 10 publications

(20 citation statements)

References 18 publications

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“…The present study has confirmed the diversity of hormonal waves in normally cycling women in terms of amplitude, wavelength, relative timing, and wave profile [1,[7][8][9]. This diversity was observed not only between women but also between different cycles in a single woman.…”

Section: Resultssupporting

confidence: 85%

“…In our view, hormone profiles are characterized by the occurrence of one or several waves. Each wave exhibits specific characteristics: i) Amplitude reflects the hormone concentration (e.g., follicular stimulating hormone (FSH) shows one peak during the early pre-ovulatory phase and another peak immediately before ovulation; the amplitudes of these two peaks vary between women and between cycles of a given woman [5,6]); ii) Wavelength reflects the duration of the hormone change (e.g., the length of the luteinizing hormone (LH) peak may range from a single day to about a week [7,8]); iii) Timing relative to the other hormone waves (e.g., during the luteal phase, the onset of the progesterone plateau may occur immediately before or after ovulation [9,10]); iv) Profile, which may have a triangular, arch, or plateau form [1]. Describing a hormonal profile requires that each of these four characteristics be taken into account.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Quadriparametric Model to Describe the Diversity of Waves Applied to Hormonal Data

Abdullah¹,

Bouchard²,

Klich³

et al. 2018

Methods Inf Med

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Section: Resultssupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

A Quadriparametric Model to Describe the Diversity of Waves Applied to Hormonal Data

Abdullah¹,

Bouchard²,

Klich³

et al. 2018

Methods Inf Med

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“…Other commonly used markers such as basal body temperature may be useful as well for the end of the fertile window ( 18 ) but may be less precise ( 19 ). In addition, development of urinary hormone monitors that provide quantitative results for various hormones may give relevant detailed information to determine whether an individual woman’s levels were changing from her particular baseline ( 19 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

Urinary Luteinizing Hormone Tests: Which Concentration Threshold Best Predicts Ovulation?

Leiva

Bouchard

Abdullah

et al. 2017

Front. Public Health

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ObjectiveTo study the best possible luteinizing hormone (LH) threshold to predict ovulation within the 24, 48, and 72 h.DesignObservational study.SettingMulticenter collaborative study.PatientsA total of 107 women.InterventionsWomen collected daily first morning urine for hormonal assessment and underwent serial ovarian ultrasound. This is a secondary analysis of 283 cycles.Main outcome measuresThe sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were estimated for varying ranges of LH thresholds. Receiver operating characteristic curves and cost–benefit ratios were used to estimate the best thresholds to predict ovulation.ResultsThe best scenario to predict ovulation at random was within 24 h after the first single positive test. The false-positive rate was found to increase as (1) the cycle progressed or (2) two or three consecutive tests were used, or (3) ovulation was predicted within 48 or 72 h. Testing earlier in the cycle increases the predictive value of the test. The ideal thresholds to predict ovulation ranged between 25 and 30 mIU/ml with a PPV (50–60%), NPV (98%), LR+ (20–30), and LR− (0.5). At least, one day with LH ≥25 mIU/ml followed by three negatives (LH <25) occurred before ovulation in 31% of all cycles. When used throughout the cycle and evaluated together, peak-fertility type mucus with a positive LH test ≥25 mIU/ml provides a higher specificity than either mucus or LH testing alone (97–99 vs. 77–95 vs. 91%, respectively).ConclusionWe identified that beginning LH testing earlier in the cycle (day 7) with a threshold of 25–30 mIU/ml may present the best predictive value for ovulation within 24 h. However, prediction by LH testing alone may be affected negatively by several confounding factors so LH testing alone should not be used to define the end of the fertile window. Complementary markers should be further investigated to predict ovulation and identify the fertile window. The use of the peak cervical mucus along with an LH test may provide a higher specificity and predictive value than either of them alone. We recommend that manufacturers disclose their tests’ threshold to the public.

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“…Irrespective of the sampling regime, the void volume and, often, the time between voids vary, so it is necessary to account for the resulting changes in quantitative assays of any urinary analyte (Brown et al, 2018). The natural approach wherever high quality data are required is simply to measure the urine production rate, as has routinely been done by users of the Ovarian Monitor (Brown et al, 1989;Blackwell et al, 2003;Blackwell et al, 2012;Blackwell et al, 2013;Blackwell et al, 2016). The analyte excretion rate is then calculated by multiplying the analyte concentration by the urine production rate .…”

Section: Introductionmentioning

confidence: 99%

On the distribution of urine output in normally cycling women

Cooke

Blackwell

Brown

2019

Biometrical Letters

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SummaryIt has been suggested that it is possible to monitor the menstrual cycle by measuring the concentration of urinary reproductive steroids. This neglects the variation in void volume and in urine production rate. In neither case has any systematic analysis been reported previously. Overnight urine samples were collected each day for one complete cycle by 24 women and the void volumes and intervoid times were recorded. The void volume and urine production rate were approximately lognormally distributed and the intervoid time was approximately normally distributed. Using these distributions we consider the implications of the variation in void volume and urine production rate for the comparison of the concentrations of a urinary analyte in two samples.

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Monitoring of ovarian activity by measurement of urinary excretion rates using the Ovarian Monitor, Part IV: the relationship of the pregnanediol glucuronide threshold to basal body temperature and cervical mucus as markers for the beginning of the post-ovulatory infertile period

Cited by 10 publications

References 18 publications

A Quadriparametric Model to Describe the Diversity of Waves Applied to Hormonal Data

A Quadriparametric Model to Describe the Diversity of Waves Applied to Hormonal Data

Urinary Luteinizing Hormone Tests: Which Concentration Threshold Best Predicts Ovulation?

On the distribution of urine output in normally cycling women

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