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Fertil Steril. 2014 Aug;102(2):511-518.e2. doi: 10.1016/j.fertnstert.2014.04.035. Epub 2014 May 27.

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

Author information

1
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland; Department of Public Health and Nursing, Westminster College, Salt Lake City, Utah.
2
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland.
3
Division of Biostatistics and Epidemiology, University of Massachusetts School of Public Health and Health Sciences, Amherst, Massachusetts.
4
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland; Program of Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland.
5
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland; Department of Global and Community Health, George Mason University, Fairfax, Virginia.
6
Department of Social and Preventive Medicine, University at Buffalo, Buffalo, New York.
7
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland; Department of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
8
Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland. Electronic address: schistee@mail.nih.gov.

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.

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 E2, P, and LH concentrations.

RESULT(S):

Algorithms based on serum LH, E2, 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 E2 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.

KEYWORDS:

Ovulation; estradiol; luteinizing hormone; menstrual cycles; progesterone

PMID:
24875398
PMCID:
PMC4119548
[Indexed for MEDLINE]
Free PMC Article
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