title: Characterizing the reproductive hormone milieu in infertile women with diminished ovarian reserve.
abstract: OBJECTIVE
  To elucidate the reproductive hormone profiles in association with a diagnosis of diminished ovarian reserve (DOR).
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Academic tertiary care infertility practice.
  
  
  METHODS
  Eight regularly cycling infertile women diagnosed with DOR as the underlying contributor to infertility and 14 age-comparable healthy controls.
  
  
  METHODS
  Daily morning urine voids were collected during one menstrual cycle.
  
  
  METHODS
  Urinary excretion of gonadotropins (FSH, LH) and metabolites of estrogen (E; estrone conjugate) and P (pregnanediol 3 glucoronide) during an entire menstrual cycle in women with DOR and healthy controls.
  
  
  RESULTS
  Women with DOR demonstrated significantly higher urinary FSH levels in the early follicular phase, exaggerated amplitudes, significantly protracted durations of LH, concomitant FSH surges, and significantly impaired luteal phase urinary excretions of estrone conjugate and pregnanediol 3 glucoronide compared with the controls.
  
  
  CONCLUSIONS
  Women with DOR demonstrate reproductive hormone profiles that are distinct from age-comparable controls, share similarities with profiles previously described during menopause transition, as well as exhibit unique features not previously recognized in the context of reproductive aging.
authors.affiliation: Department of Obstetrics & Gynecology and Reproductive Sciences, Division of Reproductive Endocrinology & Infertility, Yale University School of Medicine, 333 Cedar Street, P.O. Box 208063, New Haven, CT 06520, USA. lubnapal@aol.com
authors.forename: Lubna
authors.initials: L
authors.lastname: Pal
authors.forename: Katie
authors.initials: K
authors.lastname: Zhang
authors.forename: Gohar
authors.initials: G
authors.lastname: Zeitlian
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000652:urine; D004967:Estrogens / Q000652:urine*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000652:urine*; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000652:urine*; D007986:Luteinizing Hormone / Q000652:urine*; D010053:Ovary / Q000378:metabolism*; D011276:Pregnanediol / Q000031:analogs & derivatives* / Q000652:urine; D016649:Primary Ovarian Insufficiency / Q000175:diagnosis / Q000652:urine; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004967:Estrogens; C022270:pregnanediol-3 alpha-glucuronide; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D011276:Pregnanediol