Reliability of ovulation tests in infertile women

Guermandi E; Vegetti W; Bianchi MM; Uglietti A; Ragni G; Crosignani P

doi:10.1016/s0029-7844(00)01083-8

Research Methods Measurement and Statistics

Reliability of ovulation tests in infertile women

Guermandi E, Vegetti W, Bianchi MM, Uglietti A, Ragni G, Crosignani P

Published January 12, 2001 Obstetrics and Gynecology, 97(1), 92-96

DOI 10.1016/s0029-7844(00)01083-8 PMID 11152915

RRM Academy Synopsis

Home urine LH tests preceded ovulation in every ovulatory cycle

Home urine LH tests turned positive before the follicle ruptured in every ovulatory cycle. In a 2001 Italian study, 101 infertile women with regular cycles tried four ovulation methods for one cycle each. Ultrasound was the check. Temperature charts and ultrasound agreed in about 3 out of 4 cases.

Key Findings

Ultrasound showed follicle growth and evidence of ovulation in 97 of 101 cycles (96%).
The LH surge preceded follicle rupture in all cycles, but the gap varied widely, up to about 72 hours. Three cycles had a positive LH test and no rupture.
Basal body temperature (BBT) and ultrasound agreed in 74% of cases. BBT could not be assessed in 11 cycles, and the timing of the BBT nadir varied widely.
Midluteal serum progesterone showed ovulatory values in 93 women, and ovulation agreed with ultrasound in 90 women.

Interpretation

This single-center study followed 101 infertile women for one cycle each. They were 24 to 38 years old, with regular cycles and normal body weight. Ultrasound was the reference test for ovulation. The authors report that one midluteal progesterone test worked as well as repeated tests. The findings support larger studies of these ovulation-tracking methods.

RRM Context

The authors note that ultrasound showed true ovulation in three cycles. Those cycles had a positive LH test but no follicle rupture. Ultrasound ruled out luteinized unruptured follicle syndrome there. Fertility awareness methods and other cycle charting use similar signs, like body temperature shifts and LH surge timing, to find the fertile window.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objective

To assess the reliability of the most widely used clinical methods for predicting or confirming ovulation.

Methods

We monitored spontaneous cycles in 101 infertile women using basal body temperature (BBT), transvaginal ultrasound, a urinary stick system for LH surge, and three serum progesterone measurements in the midluteal phase. Transvaginal ultrasound monitoring was standard for ovulation detection and sensitivity. We calculated specificity and accuracy of each method compared with that standard.

Results

Follicular development and ultrasound evidence of ovulation were confirmed in 97 of 101 cycles (96%). Urinary LH surge preceded follicular rupture assessed by ultrasonography in all cycles and showed concordance with ultrasound-evidenced ovulation in 98 of 101 cases. The timing of BBT nadir had wide variability, and BBT and ultrasonography agreed in a similar percentage of cases (74%). Midluteal serum progesterone assessments showed ovulatory values in 93 subjects, and ovulation was concordant with ultrasonography in 90 subjects.

Conclusion

Urinary LH was accurate in predicting ovulation with ultrasonography as the standard for detection, but time varied widely. The nadir of BBT predicted ovulation poorly. The BBT chart was less accurate for confirming ovulation, whereas a single serum progesterone assessment in midluteal phase seemed as effective as repeated serum progesterone measures.

Topics

Research Methods › Measurement and Statistics › Instrument Development and Validation · Diagnostics › Cycle Biomarkers › Ovulation Detection · Menstrual Cycle › Cycle Biomarkers › Hormonal Markers

PMID 11152915 11152915 DOI 10.1016/s0029-7844(00)01083-8 10.1016/s0029-7844(00)01083-8 Guermandi et al. 2001, Guermandi 2001

Keywords

Adolescent, Adult, Body Temperature, Female, Humans, Luteinizing Hormone/urine, Ovulation Detection/methods, Progesterone/blood, Reproducibility of Results, Sensitivity and Specificity, Ultrasonography, Vagina/diagnostic Imaging, Progesterone, Luteinizing Hormone

Reliability of ovulation tests in infertile women

Home urine LH tests preceded ovulation in every ovulatory cycle

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

Optimal use of infertility diagnostic tests and treatments. The ESHRE Capri Workshop Group

Menstrual characteristics in women with and without endometriosis

Endometriosis and ovarian cancer

Related research

Ovulation detection methods for urinary hormones: precision, daily and intermittent sampling and a combined hierarchical method

Determination of luteal phase length by quantitative basal temperature methods: validation against the midcycle LH peak

Temporal relationship and reliability of the clinical, hormonal, and ultrasonographic indices of ovulation in infertile women

The prediction of ovulation: a comparison of the basal body temperature graph, cervical mucus score, and real-time pelvic ultrasonography

Keywords