URINARY PROGESTERONE AND PREGNANEDIOL - USE FOR MONITORING PROGESTERONE TREATMENT

Citation
Fz. Stanczyk et al., URINARY PROGESTERONE AND PREGNANEDIOL - USE FOR MONITORING PROGESTERONE TREATMENT, Journal of reproductive medicine, 42(4), 1997, pp. 216-222
Citations number
7
Categorie Soggetti
Obsetric & Gynecology
ISSN journal
00247758
Volume
42
Issue
4
Year of publication
1997
Pages
216 - 222
Database
ISI
SICI code
0024-7758(1997)42:4<216:UPAP-U>2.0.ZU;2-4
Abstract
OBJECTIVE: To compare progesterone (P) and pregnanediol glucuronide (P DG) levels in urine with respect to their potential use for monitoring luteal activity and P treatment. STUDY DESIGN: Two different experime nts were carried out. In the first experiment, each of seven normal, o vulatory women collected first morning urines daily throughout an enti re menstrual cycle. The day of ovulation was determined by transvagina l ultrasound scanning. P, PDG, estrone glucuronide, luteinizing hormon e and creatinine were measured in each urine specimen. In the second e xperiment, each of three normal, ovulatory women was given a single or al dose of 200 mg of micronized P and, 2 days later, a single intramus cular injection of 25 mg of P during days 2-5 of the cycle. Blood and urine were collected prior to each treatment and 1, 4, 8, 12 and 24 ho urs after treatment. P was measured in both serum and urine; PDG was q uantified only in urine. RESULTS: The mean initial rises and peak days , as well as the patterns of urinary excretion of P and PDG during the menstrual cycles, were similar; however, the variability of PDG was m uch greater. Concentrations of PDG were 1,000-4,000 times greater than those of P. A significant correlation was observed between urinary P and PDG. Following either intramuscular or oral P treatment, serum P l evels rose rapidly and reached peak levels (7.0-11.8 ng/ML) by one hou r. In contrast, both urinary P and PDG peaked considerably later (4-12 hours). Twenty-four hours after intramuscular treatment, serum and ur inary P and urinary PDG were still elevated. Following oral treatment the levels of these compounds decreased after peaking and were 10- to 20-fold lower at 24 hours. Also, after oral P treatment, urinary PDG l evels were considerably higher and more variable as compared to urinar y P levels. CONCLUSION: Urinary P appears to be as good a clinical mar ker of luteal activity and therapeutic P administration as PDG and may be measured in place of this metabolite. There appears to be greater variability in urinary PDG as compared to urinary P when P is administ ered.