Characteristics of the urinary luteinizing hormone surge in young ovulatory women.
OBJECTIVE
To define characteristics of the luteinizing hormone (LH) surge in urine.


METHODS
Observational study.


METHODS
Academic center.


METHODS
46 women aged 20 to 35 years with regular menstrual cycles.


METHODS
Collected first morning urine daily, throughout one menstrual cycle.


METHODS
Urinary LH, follicle-stimulating hormone (FSH), estrone conjugate (E1C), and pregnanediol-3-glucuronide (PDG).


RESULTS
Three women lacked LH surges. Mean LH surge: start = day 14.5 (+/-3.6 SD) (range: 9-26); peak = 41.2 mIU/mg creatinine (+/-20 SD) (range: 12.1-104.0); fold increase = 7.7 (+/-3.0 SD) (range: 2.5-14.8); duration = 7.6 days (+/-1.5 SD) (range: 5-11). The onset of LH surge was of two types: rapid onset (within 1 day) (42.9%) or gradual onset (2 to 6 days) (57.1%). Configurations of LH surges were of three types: spike (41.9%), biphasic (44.2%), or plateau (13.9%). All LH surges demonstrated a gradual decrease to baseline. Three women (7%) did not have FSH rises coincident with LH surges. All displayed E1C rises during the middle to late follicular phase.


CONCLUSIONS
The LH surges that result in ovulation are extremely variable in configuration, amplitude, and duration. The FSH rise does not seem essential for ovulation. However, an E1C rise occurred in all cycles, confirming the critical role of estrogen in induction of the LH surge.
Park
Susanna J
SJ
Department of Obstetrics, Gynecology and Women's Health, UMDNJ New Jersey Medical School, Newark, New Jersey 07103, USA. parksj@umdnj.edu
Goldsmith
Laura T
LT
Skurnick
Joan H
JH
Wojtczuk
Andrea
A
Weiss
Gerson
G
D000328:Adult; D015992:Body Mass Index; D004967:Estrogens / Q000652:urine; D005640:Follicle Stimulating Hormone / Q000652:urine; D006801:Humans; D007986:Luteinizing Hormone / Q000652:urine*; D008597:Menstrual Cycle / Q000502:physiology*; D010060:Ovulation / Q000502:physiology*; D018579:Patient Selection; D011276:Pregnanediol / Q000031:analogs & derivatives / Q000652:urine; D012016:Reference Values
D004967:Estrogens; C022270:pregnanediol-3 alpha-glucuronide; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D011276:Pregnanediol