title: Relationships between the luteinizing hormone surge and other characteristics of the menstrual cycle in normally ovulating women.
abstract: OBJECTIVE
  To describe the LH surge variants in ovulating women and analyze their relationship with the day of ovulation and other hormone levels.
  
  
  METHODS
  Secondary analysis of a prospective cohort observational study.
  
  
  METHODS
  Eight natural family planning clinics.
  
  
  METHODS
  Normally fertile women (n = 107) over 283 cycles.
  
  
  METHODS
  Women collected daily first morning urine, charted basal body temperature and cervical mucus discharge, and underwent serial ovarian ultrasound.
  
  
  METHODS
  Urinary LH, FSH, estrone-3-glucuronide (E3G), pregnanediol-3α-glucuronide (PDG), and day of ovulation by ultrasound (US-DO).
  
  
  RESULTS
  Individual LH surges were extremely variable in configuration, amplitude, and duration. The study also showed that LH surges marked by several peaks were associated with statistically significant smaller follicle sizes before rupture and lower LH level on the day of ovulation. LH surges lasting >3 days after ovulation were associated with a lower E3G before ovulation, a smaller corpus luteum 2 days after ovulation, and a lower PDG value during the first 4 days after ovulation.
  
  
  CONCLUSIONS
  In clinical practice, LH profiles should be compared with the range of profiles observed in normally fertile cycles, not with the mean profile.
authors.affiliation: Service de Biostatistique, Hospices Civils de Lyon, Lyon, France.
authors.forename: Ana
authors.initials: A
authors.lastname: Direito
authors.affiliation: Service de Biostatistique, Hospices Civils de Lyon, Lyon, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Bailly
authors.affiliation: Service de Pédiatrie, Centre Hospitalo-Universitaire Arnaud de Villeneuve, Montpellier, France.
authors.forename: Aude
authors.initials: A
authors.lastname: Mariani
authors.affiliation: Service de Biostatistique, Hospices Civils de Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, Villeurbanne, France; CNRS, UMR5558, Equipe Biotatistique-Santé, Laboratoire de Biométrie et Biologie Evolutive, Villeurbanne, France. Electronic address: rene.ecochard@chu-lyon.fr.
authors.forename: René
authors.initials: R
authors.lastname: Ecochard
mesh_terms: D000293:Adolescent; D000328:Adult; D001831:Body Temperature / Q000502:physiology; D002582:Cervix Mucus / Q000502:physiology; D015331:Cohort Studies; D004970:Estrone / Q000031:analogs & derivatives / Q000652:urine; D005260:Female; D005640:Follicle Stimulating Hormone / Q000652:urine; D006801:Humans; D007986:Luteinizing Hormone / Q000652:urine*; D008597:Menstrual Cycle / Q000502:physiology* / Q000652:urine*; D008875:Middle Aged; D010053:Ovary / Q000000981:diagnostic imaging; D010060:Ovulation / Q000502:physiology* / Q000652:urine*; D011276:Pregnanediol / Q000031:analogs & derivatives / Q000652:urine; D011446:Prospective Studies; D014463:Ultrasonography; D055815:Young Adult
chemical_list: C022270:pregnanediol-3 alpha-glucuronide; C015856:estrone-3-glucuronide; D004970:Estrone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D011276:Pregnanediol