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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

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Volume 53, Issue 7


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

Sarah Johnson / Sarah Weddell / Sonya Godbert / Guenter Freundl
  • green-ivf, Grevenbroich Endocrinology- and IVF-Center and Department of Gynecology and Obstetrics, University of Cologne, Grevenbroich, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Judith Roos
  • green-ivf, Grevenbroich Endocrinology- and IVF-Center and Department of Gynecology and Obstetrics, University of Cologne, Grevenbroich, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Christian Gnoth
  • green-ivf, Grevenbroich Endocrinology- and IVF-Center and Department of Gynecology and Obstetrics, University of Cologne, Grevenbroich, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2015-01-17 | DOI: https://doi.org/10.1515/cclm-2014-1087


Background: Urinary hormone level analysis provides valuable fertility status information; however, previous studies have not referenced levels to the ovulation day, or have used outdated methods. This study aimed to produce reproductive hormone ranges referenced to ovulation day determined by ultrasound.

Methods: Women aged 18–40 years (no reported infertility) collected daily urine samples for one complete menstrual cycle. Urinary luteinising hormone (LH), estrone-3-glucuronide (E3G, an estradiol metabolite), follicle stimulating hormone (FSH) and pregnanediol-3-glucuronide (P3G, a progesterone metabolite) were measured using previously validated assays. Volunteers underwent trans-vaginal ultrasound every 2 days until the dominant ovarian follicle size reached 16 mm, when daily scans were performed until ovulation was observed. Data were analysed to create hormone ranges referenced to the day of objective ovulation as determined by ultrasound.

Results: In 40 volunteers, mean age 28.9 years, urinary LH surge always preceded ovulation with a mean of 0.81 days; thus LH is an excellent assay-independent predictor of ovulation. The timing of peak LH was assay-dependent and could be post-ovulatory; therefore should no longer be used to predict/determine ovulation. Urinary P3G rose from baseline after ovulation in all volunteers, peaking a median of 7.5 days following ovulation. Median urinary peak E3G and FSH levels occurred 0.5 days prior to ovulation. A persistent rise in urinary E3G was observed from approximately 3 days pre- until 5 days post-ovulation.

Conclusions: This study provides reproductive hormone ranges referenced to the actual day of ovulation as determined by ultrasound, to facilitate examination of menstrual cycle endocrinology.

Keywords: estrone-3-glucuronide; follicle stimulating hormone; hormone ranges; luteinising hormone; menstrual cycle; ovulation; pregnanediol-3-glucuronide


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About the article

Corresponding author: Sarah Johnson, Head of Regulatory and Clinical Affairs, SPD Development Co., Ltd, Priory Business Park, Bedford, MK44 3UP, UK, Phone: +44 1234 835 486, Fax: +44 1234 835 006, E-mail:

Received: 2014-11-05

Accepted: 2014-12-11

Published Online: 2015-01-17

Published in Print: 2015-06-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 53, Issue 7, Pages 1099–1108, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2014-1087.

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