The use of estrone-3-glucuronide and pregnanediol-3-glucuronide excretion rates to navigate the continuum of ovarian activity

Blackwell, Leonard F., Cooke, Delwyn G., and Brown, Simon (2018) The use of estrone-3-glucuronide and pregnanediol-3-glucuronide excretion rates to navigate the continuum of ovarian activity. Frontiers in Public Health, 6. 153.

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Abstract

The patterns of a woman’s normal ovarian activity can take many forms from childhood to menopause. These patterns lie on a continuum ranging from no ovarian activity to a fully fertile ovulatory cycle, but among the other defined patterns are cycles with anovulatory ovarian activity, including luteinized unruptured follicles (LUFs), and ovulatory cycles with deficient or short luteal phases. For any woman, these patterns can occur in any order, and one can merge into the next, without an intervening bleed, or be missed entirely. Consequently, it is not yet possible to predict the pattern of a future cycle, but it is possible to use our knowledge of the continuum to interpret the current cycle, which has clear implications for the management of personal fertility. An individual’s position in the continuum can be monitored directly in real time by daily monitoring of ovarian hormone excretion rates, without either calendar-type calculations or reference to population means and standard deviations. The excretion of urinary estrone glucuronide (E1G) gives a direct measure of follicular growth, and the post-ovulatory rise in urinary pregnanediol glucuronide (PdG) following an E1G peak provides good evidence of ovulation. Specific values of the PdG excretion rate can be used to determine whether a cycle is anovulatory with or without a LUF, or is ovulatory and infertile or ovulatory and fertile. These specific values are important signposts for navigating the continuum. For a woman to take advantage of the knowledge of the continuum, the data must be reliable, and their interpretation has to be based on the underlying science and provided in an appropriate form. We discuss the various factors involved in acquiring and providing such information to enable each woman to navigate her own reproductive life.

Item ID: 53944
Item Type: Article (Research - C1)
ISSN: 2296-2565
Keywords: fertility; home urine test; menstrual cycle; estrone glucuronide; pregnanediol glucuronide
Copyright Information: Copyright © 2018 Blackwell, Cooke and Brown. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Date Deposited: 28 Aug 2018 01:03
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1114 Paediatrics and Reproductive Medicine > 111404 Reproduction @ 50%
03 CHEMICAL SCIENCES > 0301 Analytical Chemistry > 030104 Immunological and Bioassay Methods @ 30%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110306 Endocrinology @ 20%
SEO Codes: 97 EXPANDING KNOWLEDGE > 970111 Expanding Knowledge in the Medical and Health Sciences @ 40%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920507 Womens Health @ 60%
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