Validating At-Home Urinary Hormone Measurements in Postpartum and Perimenopause Fertility Transitions

Thomas P Bouchard; Patricia K Doyle-Baker; Paul J Yong; Richard Fehring; Mary Schneider

doi:10.1089/whr.2024.0157

Research Methods · Measurement and Statistics

Validating At-Home Urinary Hormone Measurements in Postpartum and Perimenopause Fertility Transitions

Bouchard TP, Doyle-Baker PK, Yong PJ, Fehring R, Schneider M

Published March 28, 2025 Women's health reports (New Rochelle, N.Y.), 6(1), 369-376

DOI 10.1089/whr.2024.0157 PMID 40308373 PMC PMC12040536

RRM Academy Synopsis

Mira matched ClearBlue LH surges in perimenopause, postpartum cycles

In 16 women, Mira's LH surge timing agreed with ClearBlue's in perimenopause and later postpartum cycles. This look-back study had each woman use both home urine monitors. Agreement was poor before periods returned after birth.

Study at a glance, look-back study of 16 women: Mira and ClearBlue agreed on LH surge days after periods returned. Source: Bouchard TP et al., 2025, PMID 40308373.

Key Findings

Mira and ClearBlue surge days showed good agreement (no significant difference) in postpartum cycles after the first period and in perimenopause.
Agreement was poor during postpartum amenorrhea, before the first postpartum period (p = 0.003).
Mira's LH surge fell within 1 day of ClearBlue's in 71% of postpartum surges and 82% of perimenopause surges. The earlier pilot of regular cycles found 95%.
Mira's estrone-3-glucuronide (E13G) levels were significantly higher on ClearBlue "High" than "Low" days in every group. LH levels were higher on "Peak" than "High" days (all p < 0.001).

Interpretation

The study used LH data that 16 women had already collected at home with both monitors. Earlier research checked ClearBlue against ultrasound and blood hormone tests, which makes ClearBlue the reference monitor here. Both monitors picked up extra LH surges during postpartum amenorrhea, before periods returned. The authors call these non-ovulatory peaks. Even more such peaks showed up during perimenopause. The authors note the small sample size. They say the next step is to test Mira directly against ultrasound and blood hormone measures.

RRM Context

Fertility awareness-based methods track ovulation. Birth and perimenopause make that harder to do. The authors say daily hormone readings help most in these phases, when estrogen can rise without ovulation. They add that these readings catch changes that threshold tests miss.

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

Abstract

Background

Measuring quantitative menstrual cycle hormones at home may help women better understand their postpartum and perimenopause fertility transitions, but these quantitative fertility monitors require validation.

Materials and Methods

This study included 16 North American women, aged 28-51, during either the postpartum (n = 8, cycles = 18) or perimenopause (n = 8, cycles = 35) fertility transitions testing daily first-morning urine testing with both the Mira Monitor and ClearBlue Fertility Monitor (CBFM) along with menstrual cycle parameter tracking. The main outcome measures were a rise in estrone-3-glucuronide (E13G) and luteinizing hormone (LH) urine hormone values from the Mira monitor correlated to low, high, or peak values on the CBFM.

Results

Both in the postpartum and perimenopause transitions, the identification of the day of ovulation based on the LH surge on the Mira and CBFM monitors was highly correlated (R = 0.94 and 0.83, p < 0.001). The E13G levels on the Mira monitor were significantly higher for a CBFM reading of "High" compared with "Low" for both the postpartum and perimenopausal cycles (all p < 0.001). Similarly, the LH levels on the Mira monitor were significantly higher for a CBFM reading of "Peak" (LH surge) compared with "High" for both the postpartum and perimenopausal cycles (all p < 0.001).

Conclusions

The LH surge and levels of E13G in urine identified on the quantitative Mira fertility monitor strongly correlate to the LH surge and the shift from low to high on the CBFM during the postpartum and perimenopause transitions.

Topics

Research Methods › Measurement and Statistics › Instrument Development and Validation · Reproductive Endocrinology › Ovarian Hormones › Estrogen · Menstrual Cycle › Cycle Biomarkers › Hormonal Markers

Thomas P Bouchard, Patricia K Doyle-Baker, Paul J Yong, Richard Fehring, Mary Schneider

Tom Bouchard, T Bouchard, Pat Doyle-Baker, Trish Doyle-Baker, P Doyle-Baker, P Yong, Rick Fehring, Dick Fehring, Rich Fehring, R Fehring, M Schneider

PMID 40308373 40308373 DOI 10.1089/whr.2024.0157 10.1089/whr.2024.0157 Bouchard et al. 2025, Bouchard 2025

Validating At-Home Urinary Hormone Measurements in Postpartum and Perimenopause Fertility Transitions

Mira matched ClearBlue LH surges in perimenopause, postpartum cycles

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

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