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Urinary follicle-stimulating hormone as a measure of natural fertility in a community cohort.

Steiner AZ; Long DL; Herring AH; Kesner JS; Meadows JW; Baird DD

Reprod Sci 2013 May; 20(5):549-556

https://doi.org/10.1177/1933719112459226

20042657

High serum follicle-stimulating hormone (FSH) levels have been associated with diminished ovarian reserve; however, the association between high urinary FSH and reduced natural fertility has yet to be established. We sought to characterize the relationship between a single or multiple measurements of early follicular phase urinary FSH and fertility. Women (n = 209), 30 to 44 years old with no history of infertility, who had been trying to conceive for less than 3 months, provided early follicular phase urine. Participants subsequently kept a diary to record bleeding and intercourse and conducted standardized pregnancy testing for up to 6 months. A subset of women (N = 95) collected urine on cycle day 3 for up to 6 cycles. Urine was analyzed for FSH and creatinine (cr) corrected. Proportional hazard models were used to calculate fecundability ratios (FRs). Urinary FSH levels across cycles from the same woman were highly correlated (adjusted intraclass correlation = .77); within-woman variance was 3-fold lower than variance among women. Women with an initial urinary FSH level <7 mIU/mg cr exhibited a nonsignificant reduction in the probability of pregnancy (adjusted FR 0.71, 95% confidence interval [CI]: 0.45-1.13), as did women with elevated urinary FSH > / =12 mIU/mg cr; adjusted FR 0.78, 95% CI: 0.46-1.32). Using the most recent or maximum urinary FSH value did not strengthen the association. In the general population, urinary FSH levels appear to be nonlinearly associated with fertility; however, broad CIs indicate a lack of statistical significance. Repetitive testing appears to be of little benefit.

Reproductive-system; Reproductive-effects; Women; Fertility; Hormones; Hormone-activity; Urine-chemistry; Pregnancy; Sexual-reproduction; Author Keywords: fecundability; fertility; follicle-stimulating hormone; ovarian reserve; urine

Anne Z. Steiner, Department of Obstetrics and Gynecology, University of North Carolina, CB#7570, 4001 Old Clinic Building, Chapel Hill, NC 27599, USA

JSGIED

20130501

Journal Article

asteiner@med.unc.edu

2013

B20130612

5

1933-7191

DART

Agriculture, Forestry and Fishing

Reproductive Sciences

NC; OH