Extensive monitoring of the natural menstrual cycle using the serum biomarkers estradiol, luteinizing hormone and progesterone

Expected values for estradiol (E2), luteinizing hormone (LH), and progesterone determined in serum allow accurate assessment of menstrual cycle phase. Automated immunoassays demonstrate variable degrees of bias, emphasizing the need to establish method-specific reference values. We therefore establi...

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Bibliographic Details
Published in:	Practical laboratory medicine Vol. 25; p. e00211
Main Authors:	Anckaert, Ellen, Jank, Alexander, Petzold, Julia, Rohsmann, Felix, Paris, Rhonda, Renggli, Martin, Schönfeld, Kathrin, Schiettecatte, Johan, Kriner, Monika
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier B.V 01-05-2021 Elsevier
Subjects:	Estradiol Luteinizing hormone Natural menstrual cycle Normo-ovulatory Progesterone Short Communication Natural menstrual cycle CI Normo-ovulatory Luteinizing hormone Gen III Progesterone IQR LH Estradiol E2 CI, confidence interval LH, luteinizing hormone Gen III, third-generation IQR, interquartile range E2, estradiol
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Summary:	Expected values for estradiol (E2), luteinizing hormone (LH), and progesterone determined in serum allow accurate assessment of menstrual cycle phase. Automated immunoassays demonstrate variable degrees of bias, emphasizing the need to establish method-specific reference values. We therefore established method-specific reference intervals for the Elecsys® LH assay and new generation Elecsys Estradiol III and Progesterone III assays (cobas e 801 analyzer) in 85 apparently healthy women aged 22–37 (US)/18–37 (EU) years over one natural menstrual cycle. Cycle length and day of ovulation were standardized; phases were defined by LH surge and/or progesterone/E2 levels. Median (5th–95th percentile) concentrations (follicular/ovulation/luteal) were E2: 198 pmol/L (114–332), 757 pmol/L (222–1959) and 412 pmol/L (222–854); LH: 7.14 IU/L (4.78–13.2), 22.6 IU/L (8.11–72.7) and 6.24 IU/L (2.73–13.1); progesterone: 0.212 nmol/L (0.159–0.616), 1.81 nmol/L (0.175–13.2) and 28.8 nmol/L (13.1–46.3). Sub-phase (early/intermediate/late) reference values were also determined for follicular and luteal phases. This multicenter study established reliable, method-specific E2, LH and progesterone reference values that could assist clinical decision-making in women with fertility disorders and monitoring of natural cycles in assisted reproductive treatment. •E2, LH and progesterone are biomarkers for assessing natural menstrual cycle phase.•These biomarkers support diagnosis, monitoring and treatment of fertility disorders.•E2, LH and progesterone profiles were derived using new generation Elecsys® assays.•Expected serum values are presented for each menstrual cycle phase and sub-phase.•Data will inform clinical decision-making for women with fertility disorders.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2352-5517 2352-5517
DOI:	10.1016/j.plabm.2021.e00211