Purpose To determine whether an optimal method exists\nfor the detection of the luteinising hormone (LH) surge\nonset in research datasets of urinary hormonal profiles of\nmenstrual cycles.\nMethods The scientific literature was searched to compare\npublished methodologies for detection of the LH surge\nonset in urine. Their performance was tested using complete\nhormonal profiles from 254 ovulatory cycles from\n227 women attempting pregnancy (normal regular menstrual\ncycles; no known infertility).\nResults Three major methodologies to determine the onset\nof the LH surge in urine were identified. The key difference\nbetween these methods is how the cycle days that\ncontribute to LH baseline assessment are determined: using\nfixed days (method #1), based on peak LH day (method\n#2), based on a provisional estimate of the LH surge\n(method #3). Method #1 requires no prior cycle information,\nwhereas methods #2 and #3 need to consider complete\ncycle data. The most reliable method for calculation of\nbaseline LH was using 2 days before the estimated surge\nday, plus the previous 4/5 days.\nConclusions Different methods for identification of the\nurinary LH surge can provide very different determinations\nof LH surge day, thus care must be taken when comparing\nbetween studies that apply different methodologies. The\noptimal method for determining the onset of the LH surge\nin urine requires retrospective estimation of day of LH\nsurge to identify the most appropriate part of the cycle to\nconsider as the baseline. This method can be adopted for\napplication in population studies.
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