Hum. Reprod. Advance Access originally published online on June 23, 2006
Human Reproduction 2006 21(9):2272-2280; doi:10.1093/humrep/del187
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Urinary estrogen and progesterone metabolite concentrations in menstrual cycles of fertile women with non-conception, early pregnancy loss or clinical pregnancy
1 Division of Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health, Chicago, IL 2 Anhui Provincial Institute for Biomedicine, Anhui Medical University, Hefei, Anhui, China 3 Department of Environmental Health, Harvard School of Public Health 4 The Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston 5 Institute for Toxicology and Environmental Health, School of Medicine, University of California, Davis and 6 Mary Ann J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children’s Memorial Hospital and Children’s Memorial Research Center, Chicago, IL, USA
7 To whom correspondence should be addressed at: Mary Ann and J. Milburn Smith Child Health Research Program, Children’s Memorial Hospital, 2300 Children’s Plaza, Box 157, Chicago IL 60614, USA. E-mail: xbwang{at}childrensmemorial.org
BACKGROUND: Knowledge is limited of how estrogen and progesterone variability in fertile women are associated with achieving pregnancy. METHODS: From 1996 to 1998, we enrolled 347 textile workers without hormone treatment in Anhui, China, who provided daily urine and data upon stopping contraception for up to 1 year until clinical pregnancy. Urinary hCG was assayed to detect conception and early pregnancy losses. We compared urinary concentrations of estrone conjugates (E1C) and pregnanediol-3-glucuronide (PdG) in 266 clinical pregnancies, 63 early pregnancy losses and 272 non-conception cycles from 347 women and also in 94 clinical pregnancy and 94 non-conception cycles from the same women. RESULTS: Using generalized estimating equations and relative to 266 clinical pregnancy cycles, log(E1C) was lower in 272 non-conception cycles [
= –0.3 ng/mg creatinine (Cr); SE = 0.1; P < 0.0001]. On average, daily E1C was 18 ng/mg Cr lower in non-conception cycles than in clinical pregnancy cycles. Relative to 94 clinical pregnancy cycles, log(E1C) was lower in 94 non-conception cycles ( = –0.4 ng/mg Cr; SE = 0.1; P < 0.0001) from the same women (average difference in daily E1C was 20 ng/mg Cr). The odds of E1C less than the 10th percentile (<30 ng/mg Cr) were higher in early pregnancy loss cycles [odds ratio (OR) = 4.8; P = 0.0027] than in clinical pregnancy cycles in the early luteal phase. Compared with clinical pregnancy cycles, log(PdG) concentrations were lower in non-conception cycles during the follicular phase, but this analysis lacked power for multiple testing. CONCLUSIONS: Estrogen concentrations varied from cycle to cycle, and higher estrogen was associated with achieving clinical pregnancy.
Key words: estrogens/fertilization/pregnancy/progesterone/prospective study
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