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Hum. Reprod. Advance Access published online on June 23, 2006

Human Reproduction, doi:10.1093/humrep/del187
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received February 7, 2006
Revised April 19, 2006
Accepted April 25, 2006

Article

Urinary estrogen and progesterone metabolite concentrations in menstrual cycles of fertile women with non-conception, early pregnancy loss or clinical pregnancy

Scott A. Venners 1, Xue Liu 2, Melissa J. Perry 3, Susan A. Korrick 4, Zhiping Li 2, Fan Yang 2, Jianhua Yang 2, Bill L. Lasley 5, Xiping Xu 1, and Xiaobin Wang 6 *

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, Boston
4 Department of Environmental Health, Harvard School of Public Health; 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
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

* To whom correspondence should be addressed.
Xiaobin Wang, E-mail: xbwang{at}childrensmemorial.org


   Abstract

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 [{beta} = -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 ({beta} = -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.

Keywords: estrogens/fertilization/pregnancy/progesterone/prospective study.
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