Development of the first urinary reproductive hormone ranges referenced to independently determined ovulation day
Abstract
BACKGROUND: Urinary hormone level analysis provides valuable fertility status information; however, previous studies have not referenced levels to the ovulation day, or have used outdated methods. This study aimed to produce reproductive hormone ranges referenced to ovulation day determined by ultrasound. METHODS: Women aged 18-40 years (no reported infertility) collected daily urine samples for one complete menstrual cycle. Urinary luteinising hormone (LH), estrone-3-glucuronide (E3G, an estradiol metabolite), follicle stimulating hormone (FSH) and pregnanediol-3-glucuronide (P3G, a progesterone metabolite) were measured using previously validated assays. Volunteers underwent trans-vaginal ultrasound every 2 days until the dominant ovarian follicle size reached 16 mm, when daily scans were performed until ovulation was observed. Data were analysed to create hormone ranges referenced to the day of objective ovulation as determined by ultrasound. RESULTS: In 40 volunteers, mean age 28.9 years, urinary LH surge always preceded ovulation with a mean of 0.81 days; thus LH is an excellent assay-independent predictor of ovulation. The timing of peak LH was assay-dependent and could be post-ovulatory; therefore should no longer be used to predict/determine ovulation. Urinary P3G rose from baseline after ovulation in all volunteers, peaking a median of 7.5 days following ovulation. Median urinary peak E3G and FSH levels occurred 0.5 days prior to ovulation. A persistent rise in urinary E3G was observed from approximately 3 days pre- until 5 days post-ovulation. CONCLUSIONS: This study provides reproductive hormone ranges referenced to the actual day of ovulation as determined by ultrasound, to facilitate examination of menstrual cycle endocrinology.
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Ovulation tests typically measure luteinising hormone (LH) that surges ~1 day before ovulation.
“Ovulation tests typically measure luteinising hormone (LH) that surges ~1 day before ovulation (Johnson et al. 2015; Roos et al. 2015).”
From Real-life insights on menstrual cycles and ovulation using big data (2020) · cites this paper as Johnson et al. 2015
The peak fertility result refers to the LH surge and can be mapped chronologically as 1 day before ovulation.
“The peak fertility result refers to the LH surge and can be mapped chronologically as 1 day before ovulation (Johnson et al. 2015; Roos et al. 2015).”
From Real-life insights on menstrual cycles and ovulation using big data (2020) · cites this paper as Johnson et al. 2015
Some ovulation tests also measure estrone-3-glucuronide (E3G), which rises prior to the LH surge and marks the onset of the fertile window.
“Some ovulation tests also measure the oestrogen metabolite, estrone-3-glucuronide (E3G), which rises prior to the LH surge and marks the onset of the fertile window (Johnson et al. 2015; Roos et al. 2015).”
From Real-life insights on menstrual cycles and ovulation using big data (2020) · cites this paper as Johnson et al. 2015
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- Authors
- Johnson, S., Weddell, S., Godbert, S., Freundl, G., Roos, J., & Gnoth, C.
- Affiliations
- University of Cologne (DE)
- Corresponding author
- Johnson, Sarah
- Venue
- Clinical Chemistry and Laboratory Medicine (CCLM)
- Publisher
- Walter de Gruyter GmbH
- Published
- 2015-01-01
- Volume
- 53
- Issue
- 7
- Pages
- 1099-108
- ISSN
- 1434-6621 (ISSN-L)
- 1437-4331
- OpenAlex
- W2331973763
- Cited by
- 61
- References
- 41
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 1 · 2023: 7 · 2022: 7 · 2021: 3 · 2020: 14 · 2019: 6 · 2018: 9 · 2017: 1 · 2016: 3 · 2015: 3
- FWCI
- 6.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Chemistry and Laboratory Medicine (CCLM) (publishedVersion)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Keywords
- luteinizing hormone surge, estrone-3-glucuronide, follicle-stimulating hormone, pregnanediol-3-glucuronide, ovulation prediction, ovarian follicle development, reference values
- MeSH terms
- Adolescent, Adult, Female, Hormones, Humans, Ovulation, Reference Values, Urinalysis, Young Adult
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