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

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

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalFertility and Sterility
Volume102
Issue number2
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Ovulation Detection
Anovulation
Menstrual Cycle
Serum
Pregnanediol
Urine
Menstruation
Luteal Phase
Ovulation
Fertility
Cohort Studies
Outcome Assessment (Health Care)
Prospective Studies

Keywords

  • estradiol
  • luteinizing hormone
  • menstrual cycles
  • Ovulation
  • progesterone

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Lynch, K. E., Mumford, S. L., Schliep, K. C., Whitcomb, B. W., Zarek, S. M., Pollack, A. Z., ... Schisterman, E. F. (2014). Assessment of anovulation in eumenorrheic women: Comparison of ovulation detection algorithms. Fertility and Sterility, 102(2). https://doi.org/10.1016/j.fertnstert.2014.04.035

Assessment of anovulation in eumenorrheic women : Comparison of ovulation detection algorithms. / Lynch, Kristine E.; Mumford, Sunni L.; Schliep, Karen C.; Whitcomb, Brian W.; Zarek, Shvetha M.; Pollack, Anna Z.; Bertone-Johnson, Elizabeth R.; Danaher, Michelle; Wactawski-Wende, Jean; Gaskins, Audrey J.; Schisterman, Enrique F.

In: Fertility and Sterility, Vol. 102, No. 2, 2014.

Research output: Contribution to journalArticle

Lynch, KE, Mumford, SL, Schliep, KC, Whitcomb, BW, Zarek, SM, Pollack, AZ, Bertone-Johnson, ER, Danaher, M, Wactawski-Wende, J, Gaskins, AJ & Schisterman, EF 2014, 'Assessment of anovulation in eumenorrheic women: Comparison of ovulation detection algorithms', Fertility and Sterility, vol. 102, no. 2. https://doi.org/10.1016/j.fertnstert.2014.04.035
Lynch, Kristine E. ; Mumford, Sunni L. ; Schliep, Karen C. ; Whitcomb, Brian W. ; Zarek, Shvetha M. ; Pollack, Anna Z. ; Bertone-Johnson, Elizabeth R. ; Danaher, Michelle ; Wactawski-Wende, Jean ; Gaskins, Audrey J. ; Schisterman, Enrique F. / Assessment of anovulation in eumenorrheic women : Comparison of ovulation detection algorithms. In: Fertility and Sterility. 2014 ; Vol. 102, No. 2.
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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.",
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AU - Whitcomb, Brian W.

AU - Zarek, Shvetha M.

AU - Pollack, Anna Z.

AU - Bertone-Johnson, Elizabeth R.

AU - Danaher, Michelle

AU - Wactawski-Wende, Jean

AU - Gaskins, Audrey J.

AU - Schisterman, Enrique F.

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N2 - 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.

AB - 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.

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KW - progesterone

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