Use of Ovulation Predictor Kits as Adjuncts When Using Fertility Awareness Methods (FAMs): A Pilot Study

Leiva, René; Burhan, Ula; Kyrillos, Edmond; Fehring, Richard J.; McLaren, Robin; Dalzell, Catherine; Tanguay, Elizabeth

doi:10.3122/jabfm.2014.03.130255

Cited by 16 publications

(10 citation statements)

References 4 publications

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“…Home-based ovulation tests are typically designed to identify ovulation by detection of this LH surge in urine. Studies have confirmed their accuracy in detecting the LH surge relative to serum hormone levels and in predicting ovulation relative to ultrasound-detected ovulation [28][29][30][31][32]. Thus, the results of this study confirm previous findings on the accuracy of urinary hormone testing to predict the onset of the fertile window in women and the application of urinary LH surge detection for home-based fertility testing [33].…”

Section: Discussionsupporting

confidence: 90%

Development of the first urinary reproductive hormone ranges referenced to independently determined ovulation day

Johnson¹,

Weddell²,

Godbert³

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Section: Discussionsupporting

confidence: 90%

Development of the first urinary reproductive hormone ranges referenced to independently determined ovulation day

Johnson¹,

Weddell²,

Godbert³

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Commercially affordable urinary ovulation predictor tests have become commonly used by those women wanting to become pregnant since they were first introduced in the 1980s ( 1 ). In addition, they could also be used as an adjunct to Fertility Awareness Methods ( 2 ). These rapid one-step home urinary tests attempt to predict when ovulation is about to occur by measuring the luteinizing hormone (LH) surge ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Urinary Luteinizing Hormone Tests: Which Concentration Threshold Best Predicts Ovulation?

Leiva

Bouchard

Abdullah

et al. 2017

Front. Public Health

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ObjectiveTo study the best possible luteinizing hormone (LH) threshold to predict ovulation within the 24, 48, and 72 h.DesignObservational study.SettingMulticenter collaborative study.PatientsA total of 107 women.InterventionsWomen collected daily first morning urine for hormonal assessment and underwent serial ovarian ultrasound. This is a secondary analysis of 283 cycles.Main outcome measuresThe sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were estimated for varying ranges of LH thresholds. Receiver operating characteristic curves and cost–benefit ratios were used to estimate the best thresholds to predict ovulation.ResultsThe best scenario to predict ovulation at random was within 24 h after the first single positive test. The false-positive rate was found to increase as (1) the cycle progressed or (2) two or three consecutive tests were used, or (3) ovulation was predicted within 48 or 72 h. Testing earlier in the cycle increases the predictive value of the test. The ideal thresholds to predict ovulation ranged between 25 and 30 mIU/ml with a PPV (50–60%), NPV (98%), LR+ (20–30), and LR− (0.5). At least, one day with LH ≥25 mIU/ml followed by three negatives (LH <25) occurred before ovulation in 31% of all cycles. When used throughout the cycle and evaluated together, peak-fertility type mucus with a positive LH test ≥25 mIU/ml provides a higher specificity than either mucus or LH testing alone (97–99 vs. 77–95 vs. 91%, respectively).ConclusionWe identified that beginning LH testing earlier in the cycle (day 7) with a threshold of 25–30 mIU/ml may present the best predictive value for ovulation within 24 h. However, prediction by LH testing alone may be affected negatively by several confounding factors so LH testing alone should not be used to define the end of the fertile window. Complementary markers should be further investigated to predict ovulation and identify the fertile window. The use of the peak cervical mucus along with an LH test may provide a higher specificity and predictive value than either of them alone. We recommend that manufacturers disclose their tests’ threshold to the public.

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“…The addition of urinary PDG measurement could assist in determining whether a rise in LH (as shown by the Clearblue Fertility Monitor used in the Marquette Method Postpartum Protocol) was actually ovulatory. A lower-cost protocol might include the combination of mucus rating with use of LH test strips to help clarify whether peak mucus is potentially ovulatory (Leiva et al 2014), and this could be combined with subsequent measurements of PDG (Blackwell et al 2016) to guide a woman through her postpartum fertility.…”

Section: Implications and Future Directionsmentioning

confidence: 99%

Dissociation between Cervical Mucus and Urinary Hormones during the Postpartum Return of Fertility in Breastfeeding Women

et al. 2018

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Identifying the return of fertility with cervical mucus observations is challenging during the postpartum period. Use of urinary measurements of estrogen and progesterone can assist in understanding the return to fertility during this period. The purposes of this study were to describe the postpartum return of fertility by an analysis of total estrogen (TE) and pregnanediol glucuronide (PDG) profiles and to correlate these profiles with cervical mucus observations. Twenty-six participants collected urine samples during the postpartum period and recorded mucus scores. TE and PDG hormones were analyzed and compared with mucus scores. During amenorrhea, mucus reflected TE changes in only 35 percent of women; after amenorrhea, typical mucus patterns were seen in 33 percent of cycles. We concluded that postpartum mucus and hormone profiles are significantly dissociated but that monitoring urinary hormones may assist in identifying the return of fertility. We also identified different hormonal patterns in the return to fertility. The postpartum period is a challenging time for identifying the return of fertility. The purposes of this study were to describe the hormonal patterns during the return of fertility and to correlate these patterns with cervical mucus observations. Twenty-six postpartum women collected urine samples and recorded mucus scores. Urinary estrogen and progesterone hormones were analyzed and compared with mucus scores. Before the return of menses, mucus reflected hormonal changes in only 35 percent women and after first menses in 33 percent of cycles. We found that hormone profiles do not correlate well with mucus observations during the postpartum return of fertility.

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Use of Ovulation Predictor Kits as Adjuncts When Using Fertility Awareness Methods (FAMs): A Pilot Study

Cited by 16 publications

References 4 publications

Development of the first urinary reproductive hormone ranges referenced to independently determined ovulation day

Development of the first urinary reproductive hormone ranges referenced to independently determined ovulation day

Urinary Luteinizing Hormone Tests: Which Concentration Threshold Best Predicts Ovulation?

Dissociation between Cervical Mucus and Urinary Hormones during the Postpartum Return of Fertility in Breastfeeding Women

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