Luteinising hormone profiles in conception and non-conception natural cycles

Abstract

Objective: The aim of this study was to assess whether luteinising hormone (LH) surge characteristics influenced the likelihood of conceiving naturally.

Methods: This was a single-cycle, home-based, observational, case-controlled study. Volunteers collected daily urine samples for one menstrual cycle. LH was measured and the basal levels, surge day, peak day, peak concentration and magnitude of LH surges were examined. Predictive models using sociodemographic data, LH surge characteristics, and sociodemographic data combined with LH profile properties, were evaluated.

Results: The surge profile did not differ between cycles with early or late ovulation and was not affected by age or body mass index (BMI). The mean LH surge day was day 16 for both groups. Mean LH surge and concentrations did not differ between groups (surge concentration 54.8 IU/l vs. 58.2 IU/l and peak concentration 82.0 IU/l vs. 81.6 IU/l for pregnant vs. non-pregnant volunteers, respectively). Non-pregnant volunteers were more likely, however, to have a raised or a reduced basal LH on day 6 or have an atypical LH profile. Sociodemographic characteristics were significant predictors of pregnancy, and sociodemographic variable-based models had the greatest predictive ability for conception, providing up to 65% predictive accuracy.

Conclusions: Sociodemographic variables can be used to predict the likelihood of a woman conceiving naturally. Provided an LH surge is present, its profile does not relate to the likelihood of spontaneous pregnancy. The conception rate was significantly lower, however, in women with elevated or reduced basal levels of LH, suggesting that follicular maturation needs an optimal basal level of LH in natural conception cycles.

Trial registration: ClinicalTrials.gov identifier: NCT01577147.

摘要

目的：探讨黄体生成素（LH）峰值特征是否影响自然受孕的可能性。

方法：采用单周期、家庭为基础、病例对照的观察性研究。受试者每天收集一个月经周期的尿样来测定黄体生成素的基础水平、激增日、峰值日、峰值浓度和峰值强度。利用社会人口数据、LH激增特征及结合社会人口数据的LH分布特征来对预测模型进行评估。

结果：LH在排卵期早、晚期的两种峰型无明显差异, 且不受年龄和体重指数（BMI）的影响。两组平均LH峰值日均为第16天, 两组平均黄体生成素峰值和黄体生成素水平无显著性差异（孕妇组和非孕妇组的黄体生成素增加水平分别为54.8 IU/l和58.2 IU/l, 孕妇组合非孕妇组的黄体生成素峰值水平分别为82.0 IU/l和81.6 IU/l）。然而, 没有怀孕的受试者更有可能在第6天出现基础LH升高或降低, 或者出现不典型的LH。社会人口特征是怀孕的重要预测因素, 基于社会人口变量的模型对怀孕有最大的预测能力, 提供高达65%的预测准确性。

结论：社会人口变量可以用来预测女性自然受孕的可能性。如果黄体生成素激增, 其特征与自然怀孕的可能性无关。然而, 在黄体生成素基础水平升高或降低的妇女中, 受孕率明显较低, 这表明卵泡成熟需要在自然受孕周期的最佳黄体生成素基础水平。

Keywords:

• Conception
• fertility
• luteinising hormone surge
• menstrual cycle characteristics

Acknowledgements

Kathryn Charlwood, Integrated Medhealth Communication provided medical writing assistance in the form of manuscript journal styling.

Disclosure statement

SJ is an employee of SPD Development Company Ltd. CG has received consultancy fees from SPD Development Company Ltd. JS, GF and NB have no conflicts of interest to declare.

Additional information

Funding

The study was funded by SPD Development Company Ltd (Bedford, UK), a fully owned subsidiary of SPD Swiss Precision Diagnostics (Geneva, Switzerland).