Abstract
Objectives
During normal menstrual cycles, serum levels of progesterone vary widely between cycles of same woman and between women. This study investigated the profiles of pregnanediol during the luteal phase.
Methods
Data stemmed from a previous multicenter prospective observational study and concerned 107 women (who contributed 326 menstrual cycles). The study analyzed changes in observed cervical mucus discharge, various hormones in first morning urine, and serum progesterone. Transvaginal ultrasonography and cervical mucus helped identifying the day of ovulation. Changes in pregnanediol glucuronide levels during the luteal phase were examined and classified according to the length of that phase, a location parameter, and a scale parameter. Associations between nine pregnanediol glucuronide profiles and other hormone profiles were examined.
Results
Low periovulatory pregnanediol glucuronide levels and low periovulatory luteinizing hormone levels were associated with delayed increases in pregnanediol glucuronide after ovulation. That ‘delayed increase profile’ was more frequently associated with cycles with prolonged high LH levels than in cycles with rapid pregnanediol glucuronide increases. A ‘plateau-like profile’ during the luteal phase was associated with longer cycles, cycles with higher estrone-3-glucuronide and pregnanediol glucuronide during the preovulatory phase, and cycles with higher periovulatory pregnanediol glucuronide levels.
Conclusions
Distinct profiles of urinary progesterone levels are displayed during the luteal phase. These profiles relate to early hormone changes during the menstrual cycle. In everyday clinical practice, these findings provide further evidence for recommending progesterone test seven days after the mucus peak day. The search for other correlations and associations is underway.
Acknowledgments
The authors thank Drs. Sophie Dubus, Anne Leduy, Isabelle Ecochard, Marie Grisard Capelle, Enriqueta Barranco, Michele Barbato, Sandro Girotto, and Marion Gimmler from the natural family planning clinics as well as all the women who took part in this study.
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Research funding: None declared.
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Author contributions: Conceptualization, methodology, and investigation: SA, TB, RL, HB, and RE. Data curation and analysis: SA, HB, and RE. Result interpretation and validation: SA, TB, RL, HB, JI, and R. Writing, original draft: SA, TB, RL, and RE. Writing, review, and editing: TB, RL, HB, JI, and RE. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The local Institutional Review Board deemed the study exempt from review.
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