Transvaginal ultrasound (TVUS) detection of the growth and disappearance of a follicle is the gold standard technique, but it is invasive and repeated measures are often undesirable or not feasible in an outpatient setting 1, 2. The confirmation of ovulation is important for the investigation of infertility, for women planning conception and for researchers understanding the impact of interventions on ovarian function. Automated P4 may potentially be as efficacious as PDG ELISA but research from a range of clinical settings is required. In serial samples classified as (an)ovulatory by PDG, P4 Architect gave ROC AUC 0.95 (95% CI 0.89 to 1.01), with sensitivity and specificity for confirmation of ovulation of 0.90 and 0.91 at a cutoff of 1.67 μmol/mol. In women with detailed monitoring of ovulation, median (95% CI) luteal phase increase was greatest for PDG, 427% (261–661), 278% (187–354) for P4 Architect and least for P4 Cobas, 146% (130–191), p 0.92). Serial samples were assayed for P4 by Architect and PDG by ELISA.
Daily samples were assayed by two automated P4 immunoassays (Roche Cobas and Abbott Architect) and PDG ELISA. Daily urine samples from 20 cycles in 14 healthy women in whom ovulation was dated by ultrasound, and serial weekly samples from 21 women in whom ovulation was unknown were analysed. We aimed to determine whether automated immunoassay of urinary P4 was as efficacious as PDG to confirm ovulation. Urinary concentrations of the major progesterone (P4) metabolite pregnanediol-3-glucuronide (PDG) are used to confirm ovulation.
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