title: Assessment of anovulation in eumenorrheic women: comparison of ovulation detection algorithms.
abstract: OBJECTIVE
  To compare previously used algorithms to identify anovulatory menstrual cycles in women self-reporting regular menses.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Western New York.
  
  
  METHODS
  Two hundred fifty-nine healthy, regularly menstruating women followed for one (n=9) or two (n=250) menstrual cycles (2005-2007).
  
  
  METHODS
  None.
  
  
  METHODS
  Prevalence of sporadic anovulatory cycles identified using 11 previously defined algorithms that use E2, P, and LH concentrations.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland; Department of Public Health and Nursing, Westminster College, Salt Lake City, Utah.
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Lynch
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland.
authors.forename: Sunni L
authors.initials: SL
authors.lastname: Mumford
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Schliep
authors.affiliation: Division of Biostatistics and Epidemiology, University of Massachusetts School of Public Health and Health Sciences, Amherst, Massachusetts.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Whitcomb
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland; Program of Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland.
authors.forename: Shvetha M
authors.initials: SM
authors.lastname: Zarek
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland; Department of Global and Community Health, George Mason University, Fairfax, Virginia.
authors.forename: Anna Z
authors.initials: AZ
authors.lastname: Pollack
authors.affiliation: Division of Biostatistics and Epidemiology, University of Massachusetts School of Public Health and Health Sciences, Amherst, Massachusetts.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Bertone-Johnson
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland.
authors.forename: Michelle
authors.initials: M
authors.lastname: Danaher
authors.affiliation: Department of Social and Preventive Medicine, University at Buffalo, Buffalo, New York.
authors.forename: Jean
authors.initials: J
authors.lastname: Wactawski-Wende
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland; Department of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Audrey J
authors.initials: AJ
authors.lastname: Gaskins
authors.affiliation: Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland. Electronic address: schistee@mail.nih.gov.
authors.forename: Enrique F
authors.initials: EF
authors.lastname: Schisterman
mesh_terms: D000328:Adult; D000465:Algorithms; D000858:Anovulation / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000652:urine; D015415:Biomarkers / Q000652:urine; D004958:Estradiol / Q000652:urine*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007986:Luteinizing Hormone / Q000652:urine*; D008597:Menstrual Cycle / Q000652:urine*; D009518:New York / Q000453:epidemiology; D010060:Ovulation; D010061:Ovulation Detection / Q000379:methods*; D011237:Predictive Value of Tests; D015995:Prevalence; D011374:Progesterone / Q000652:urine*; D011446:Prospective Studies; D016482:Urinalysis; D055815:Young Adult
chemical_list: D015415:Biomarkers; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone
keywords: Ovulation; estradiol; luteinizing hormone; menstrual cycles; progesterone