Preimplantation urinary hormone profiles and the probability of conceptionin healthy women

Objective: To examine hormonal predictors of conception in menstrual cycles from normal women. Design: Longitudinal study. Setting: Community. Patient(s): Two hundred fifteen healthy female volunteers with no known fer tility problems who were trying to conceive. Intervention(s): Participants recorded menstrual bleeding, sexual intercour se, and collected first morning urine specimens daily from when they stoppe d contraception until they became pregnant or for 6 months if no clinical p regnancy was achieved. Measurements were made of urinary LH and urinary met abolites of estrogen and progesterone. Main Outcome Measure(s): Conception was identified by a sensitive and speci fic immunoradiometric assay for urinary hCG. Result(s): Statistical analyses of 189 conception and 409 nonconception cyc les controlled for sexual intercourse and interdependence of cycles from th e same woman. Conception was more likely in cycles with lower baseline prog esterone metabolite levels, higher ovulatory LH, and higher midluteal proge sterone. Midluteal estrogen also was elevated in conception cycles when exa mined without adjusting for other hormone levels, but this finding did not persist after multivariate adjustment. Conclusions: Menstrual cycles in normal women vary in their hormonal qualit y in ways that are predictive of cycle fertility. American Society for Repr oductive Medicine.