Identification of the LH surge by measuring intact and total immunoreactivity in urine for prediction of ovulation time

Hormones (Athens). 2022 Sep;21(3):413-420. doi: 10.1007/s42000-022-00368-9. Epub 2022 May 26.

Abstract

Objectives: In our earlier study, we separated three different molecular forms of urinary LH-ir (U-LH-ir) by gel filtration and identified them by immunoassay in urine from regularly menstruating women on periovulatory days. U-LH-ir is composed of intact luteinizing hormone (LH), its free beta-subunit (LHβ), and the core fragment of LHβ (LHβcf), the latter two establishing the non-intact portion of LH-ir. The aim was to determine whether timing of ovulation can be improved by detecting different molecular forms of U-LH-ir in women of reproductive age.

Methods: We determined intact and total U-LH-ir in 14 regularly menstruating women on consecutive periovulatory days during the menstrual cycle. Non-intact LH-ir was calculated as the arithmetic difference between total and intact LH-ir. In addition, LH-ir was determined in both serum and urine from four of the women throughout the menstrual cycle.

Results: During the LH surge, U-LH-ir consisted mainly of intact LH and presented with an abrupt increase. Intact U-LH-ir dropped rapidly within 1 day after the surge, reaching baseline levels at the end of the luteal phase. In contrast, LHβcf in urine increased further 1 day after the surge. After this, most of the U-LH-ir consisted of LHβcf and it remained strongly elevated (over fivefold compared to intact LH) for the first 3 days after the LH surge, moderately elevated (over threefold) thereafter until day + 5, and mildly elevated until day + 7.

Conclusions: Total and non-intact LH-ir are potential add-on characteristics which can be utilized in ovulation predictor kits to measure LH-ir in urine beyond the LH surge during a broader time frame, thereby paving the way for more precise prediction of the timing of ovulation than that obtained with currently available products.

Keywords: Fertility; Gonadotropin; Infertility; Luteinizing hormone; Menstruation; Ovulation; Ovulation predictor kit; Urinary.

MeSH terms

  • Estradiol
  • Female
  • Humans
  • Luteinizing Hormone*
  • Ovulation*
  • Progesterone

Substances

  • Progesterone
  • Estradiol
  • Luteinizing Hormone