Characteristics of urinary luteinizing hormone (LH) during the induction of LH surges of different magnitude in blood.

Abstract

Urinary luteinizing hormone (LH) testing has been proposed as a reliable method for the prediction of ovulation but its accuracy has been challenged by some studies. To check how accurately the oscillations of urinary LH reflected the plasma changes, surges of LH of different magnitude and duration were artificially induced in plasma and the hormone was measured simultaneously in urine. Post-menopausal women (n = 16) were stimulated during 1 week with a combination of transdermal oestradiol (400 micrograms) and i.m. progesterone (25 mg on day 4, 50 mg on day 5) to obtain an LH discharge comparable with the pre-ovulatory LH peak. A short and moderate peak of LH was induced by the i.v. injection of 100 micrograms gonadotrophin-releasing hormone (GnRH) in six premenopausal women, whereas an LH discharge of higher amplitude and longer duration was induced by a single dose of 0.3 mg s.c. buserelin. The total urine production of the day was fractionated into 8 h periods. LH was measured by a commercial radioimmunoassay. Unambiguous peaks of LH were detected in the urine of all the women stimulated with either oestradiol plus progesterone or buserelin, but in only three out of the six women receiving GnRH. The urine LH reproduced the plasma changes of the hormone with short delay since the peaks were mostly detected in the same time fraction in which the serum discharge occurred.