menotropins and estrone-3-glucuronide

A simple, rapid, and sensitive solid-phase immunoassay procedure for the determination of estrone-3-glucuronide (E1-3-G), which uses chemiluminescence as the end point in unextracted morning urine, is described. Thirty-one patients undergoing induction of ovulation in an in vitro fertilization (IVF) unit participated in the study. From day 3 of the menstrual cycle until the day of hCG administration, morning blood samples and morning urine specimens were collected for the determination of serum 17 beta-estradiol (E2) and urine E1-3-G, respectively. A good correlation was noted between E2 measured by radioimmunoassay (RIA) and the E1-3-G measured by chemiluminescence immunoassay (CIA), from day 5 up to the day of hCG administration (0.6 less than r less than 0.85, P less than 0.001). It is evident from this study that the CIA measurement of E1-3-G in morning urine is an accurate and rapid (2.5 hours) method and is convenient for monitoring induction of ovulation with human menopausal gonadotropins.

Topics: Adult; Chorionic Gonadotropin; Estrone; Female; Fertilization in Vitro; Humans; Immunologic Techniques; Luminescent Measurements; Menotropins; Ovulation Induction

HMG treatment is usually monitored by the evaluation of the cervical mucus, the determination of plasma 17 beta-estradiol, total urinary estrogens, ultrasonographic evaluation or a combination of these. We evaluated the daily validity of estrone-3-glucuronide excretion in urine as an indicator of follicular growth and maturation in 28 infertile women who were treated with HMG (Pergonal 500). Total urinary estrogens and estrone-3-glucuronide were measured in 24 h urine collections, and 11 of the women collected the early-morning urine separately. This allowed comparison of the concentrations and excretion of total estrogens and estrone-3-glucuronide of the 24 h urine with that found in the urine collected overnight. This comparison was made on 83 urine samples. The correlation between either the total excretion per 24 h or the concentration per liter in the 24 h urine collection of the two systems of determination was good in all determinations. Also in the urine collected on the day prior to HCG administration, total estrogens measurement was in good correlation with the estrone-3-glucuronide. However, there was statistically a significant difference in the concentrations of total estrogens and estrone-3-glucuronide between the women who ovulated and those who did not. Estrone-3-glucuronide, when calculated as a percentage of the total estrogens, was 60.86% in the women who ovulated and 33.15% in those who did not. These results demonstrate that although estrone-3-glucuronide reflects ovarian function in women treated with HMG, it may serve as a better predictor to ovulation.

Topics: Chorionic Gonadotropin; Estrogens; Estrone; Female; Humans; Infertility, Female; Menotropins; Ovarian Follicle; Ovulation Induction

Total 24-hour urinary oestrogen has been used extensively and proven to be reliable in monitoring gonadotrophin therapy for induction of ovulation. However, the method is time consuming for the patient and incomplete collection, as expected, is not uncommon, hence interfering with the treatment result. Oestrone-3-glucuronide in first morning urine samples has been shown to correlate well with plasma oestradiol-17 beta levels during normal menstrual cycles. A comparative study was made to examine the correlation between the levels of 24-hour urinary oestrogen and first morning urinary oestrogen in patients on gonadotrophin therapy. Creatinine levels were also determined to exclude the factor of variable excretion of oestrogen. The correlation thus found is highly significant (p less than 0.001). Hence first morning urinary oestrogen to creatinine ratios may be used to replace 24-hour urinary oestrogen in biochemical monitoring of gonadotrophin therapy.

Topics: Creatinine; Estradiol; Estrogens; Estrone; Female; Humans; Infertility, Female; Menotropins; Ovulation Induction; Pregnancy; Time Factors