Schwarz C, Irion N Fournet, Klein T Jauch, Righetti A, de Ziegler D, Bischof P
Unité de médecine de la reproduction et d'endocrinologie gynécologique, hôpital universitaire de Genève (HUG), Suisse.
Gynecol Obstet Fertil. 2006 Jun;34(6):493-8. doi: 10.1016/j.gyobfe.2006.03.003. Epub 2006 Apr 24.
The intercycle FSH signal that initiates follicular recruitment and marks the functional onset of the menstrual cycle is of small amplitude and while it commonly occurs on cycle day 3, this often varies. Hence, its identification and measurement in serum (sFSH) requires serial daily samplings. We attempted to determine whether urine measurements of FSH (uFSH) could offer a non-invasive alternative, using a model where the intercycle FSH signal is controlled by timely use of exogenous E2.
Pilot prospective trial in 21 infertile women having received E2, from day 25 of the previous cycle until the 1st Friday after menses. Blood and first void urine samples were collected, starting on the last day of E2 (baseline) for assessing FSH and creatinin. A sonogram was performed for identification of maturing follicles (>12 mm).
uFSH and uFSH/Cr showed good correlation with sFSH (R = 0.52 and 0.63, P < 0.0001 and P < 0.0001, respectively). In 15/21 patients who had an intercycle sFSH elevation, this was confirmed by uFSH elevation, both occurring within 2-4 days after stopping E2. In all these women, the sonogram showed evidence of impending ovulation. The amplitude of the uFSH signal was on average 3 times higher than its sFSH counterpart. In 6/21 women, no intercycle FSH elevation was detected and no ovulation occurred.
Our results show that the intercycle FSH signal can easily be identified and measured in urine. This novel approach permits more precise assessments of ovarian physiology than with blood measurements.
启动卵泡募集并标志月经周期功能开始的周期间促卵泡激素（FSH）信号幅度较小，虽然通常在周期第3天出现，但常常存在变化。因此，在血清中识别和测量该信号（血清FSH，sFSH）需要每日连续采样。我们试图确定通过适时使用外源性雌二醇（E2）控制周期间FSH信号的模型，尿FSH（uFSH）测量是否能提供一种非侵入性替代方法。
对21名接受E2治疗的不孕女性进行前瞻性试验，从上个周期的第25天开始直至月经后的第一个周五。从E2的最后一天（基线）开始采集血液和首次晨尿样本，用于评估FSH和肌酐。进行超声检查以识别成熟卵泡（>12毫米）。
uFSH和uFSH/肌酐与sFSH显示出良好的相关性（R分别为0.52和0.63，P均<0.0001）。在21例周期间sFSH升高的患者中，有15例uFSH升高证实了这一点，两者均在停用E2后2 - 4天内出现。在所有这些女性中，超声检查显示有即将排卵的迹象。uFSH信号的幅度平均比其sFSH对应信号高3倍。在21例女性中有6例未检测到周期间FSH升高，也未发生排卵。
我们的结果表明，周期间FSH信号可以很容易地在尿液中识别和测量。这种新方法比血液测量能更精确地评估卵巢生理功能。
