Alliende María Elena, Arraztoa José Antonio, Guajardo Ulises, Mellado Fernando
Programa de Cuidado y Estudio de la Fertilidad (PROCEF), Departamento de Obstetricia, Ginecología y Biología de la Reproducción, Universidad de los Andes, Santiago, Chile.
Facultad de Medicina, Universidad de los Andes, Santiago, Chile.
Front Public Health. 2018 May 31;6:147. doi: 10.3389/fpubh.2018.00147. eCollection 2018.
To describe and evaluate urinary hormone profiles in the luteal phase. Twenty-five healthy fertile women, with regular ovulatory pattern cycles as assessed by temperature and cervical mucus, at a university based center. Daily urinary hormonal assessment of luteinizing hormone, estrone glucuronide, and pregnanediol glucuronide. This was done during 3 or more cycles, with 78 completed cycles. Samples were analyzed by both crude levels and levels adjusted for the hormone excretion rate. Correlation between measured parameters (LH surge, vulvar mucus) was assessed with regard to their ability to detect presumed ovulation. An upper, middle, and lower tercile range for the main urinary reproductive hormones was determined and a classification system of zones proposed, considering profiles over or under the 10th percentile. Adjustment for the urine excretion rate proved useful for interpreting individual samples; this was less necessary with multiple samples over time where trends could be determined. This serial evaluation, in at least two cycles, lowered the possibility of finding an isolated luteal phase defect and helped identify the recurrence of such. Vulvar mucus findings performed well in determining the timing of ovulation. Despite the proven fertility of the study population, lower luteal phase hormones were detected in both an isolated and, in some situations, recurrent manner. A feasible method is proposed to accurately, thoroughly and reproducibly study the luteal phase in order to evaluate and treat identified abnormalities in a properly timed, restorative manner. This preliminary study provides the basis for future research, correlating urinary hormones with clinical findings, particularly those of luteal phase defects.
描述和评估黄体期的尿激素谱。在一所大学附属医院的研究中心，招募了25名健康且有生育能力的女性，她们的排卵周期规律，通过体温和宫颈黏液进行评估。对促黄体生成素、雌酮葡萄糖醛酸苷和孕二醇葡萄糖醛酸苷进行每日尿激素评估。该评估在3个或更多周期内进行，共完成78个周期。样本分析采用原始水平以及根据激素排泄率调整后的水平。评估测量参数（促黄体生成素高峰、外阴黏液）之间的相关性，以确定其检测假定排卵的能力。确定了主要尿生殖激素的上、中、下三分位数范围，并提出了一个区域分类系统，考虑高于或低于第10百分位数的激素谱。证明对尿排泄率进行调整有助于解释个体样本；对于随时间的多个样本，由于可以确定趋势，因此这种调整不太必要。至少在两个周期内进行的这种系列评估降低了发现孤立黄体期缺陷的可能性，并有助于识别此类缺陷的复发情况。外阴黏液检查在确定排卵时间方面表现良好。尽管研究人群已证实具有生育能力，但仍以孤立或在某些情况下复发的方式检测到较低的黄体期激素水平。提出了一种可行的方法，以准确、全面且可重复地研究黄体期，以便以适当的时间、恢复性的方式评估和治疗已识别的异常情况。这项初步研究为未来将尿激素与临床发现（特别是黄体期缺陷的临床发现）相关联的研究提供了基础。
