학술논문

Urinary Luteinizing Hormone Tests: Which Concentration Threshold Best Predicts Ovulation?
Document Type
article
Source
Frontiers in Public Health, Vol 5 (2017)
Subject
ovulation predictor kits
luteinizing hormone
natural family planning
fertility awareness methods
infertility
urine
Public aspects of medicine
RA1-1270
Language
English
ISSN
2296-2565
Abstract
ObjectiveTo study the best possible luteinizing hormone (LH) threshold to predict ovulation within the 24, 48, and 72 h.DesignObservational study.SettingMulticenter collaborative study.PatientsA total of 107 women.InterventionsWomen collected daily first morning urine for hormonal assessment and underwent serial ovarian ultrasound. This is a secondary analysis of 283 cycles.Main outcome measuresThe sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios were estimated for varying ranges of LH thresholds. Receiver operating characteristic curves and cost–benefit ratios were used to estimate the best thresholds to predict ovulation.ResultsThe best scenario to predict ovulation at random was within 24 h after the first single positive test. The false-positive rate was found to increase as (1) the cycle progressed or (2) two or three consecutive tests were used, or (3) ovulation was predicted within 48 or 72 h. Testing earlier in the cycle increases the predictive value of the test. The ideal thresholds to predict ovulation ranged between 25 and 30 mIU/ml with a PPV (50–60%), NPV (98%), LR+ (20–30), and LR− (0.5). At least, one day with LH ≥25 mIU/ml followed by three negatives (LH