Environmental Health Perspectives Volume 105, Number 8, August 1997
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Total Urinary Follicle Stimulating Hormone as a Biomarker for Detection of Early Pregnancy and Periimplantation Spontaneous Abortion
Qing Qiu,
1
James W. Overstreet,
1,2
Heather Todd,
1
Steven T. Nakajima,
2
Dennis R. Stewart,
2
and Bill L. Lasley
1,2
1
Institute of Toxicology and Environmental Health; and
2
Department of Obstetrics and Gynecology, School of Medicine, University of California, Davis, California 95616 USA
Abstract
Total concentrations of follicle stimulating hormone (FSH) were evaluated in daily urine samples from conceptive and nonconceptive menstrual cycles by measurement of the FSH beta subunit following treatment of the samples to dissociate the FSH heterodimer. Samples were self-collected by normal subjects during cycles in which daily blood samples also were obtained. Daily blood and urine specimens were collected prospectively from 10 subjects in conceptive cycles, which led to normal pregnancies, and from 10 subjects with bilateral tubal ligations to provide control samples from nonconceptive cycles. Mean serum and urinary FSH concentration profiles were parallel in both groups following ovulation and during the first 9 days of the luteal phase. Mean values for both serum and urinary FSH rose significantly above the postovulatory baseline by 10-12 days following the midcycle luteinizing hormone (LH) peak in nonconceptive cycles, but did not rise at any time following ovulation during conceptive cycles. Following regression analysis of the changing FSH concentrations between days 9-14 post-LH surge in conceptive cycles, a slope of
0.02 ng FSH/mg creatinine/day was selected as a cutoff point to identify conceptive cycles. There was a high concordance between the day of LH peak in serum and the day of FSH peak in urine. Therefore, in applying the algorithm, the day of FSH peak in urine was used to determine the days for which the FSH slope would be calculated, i.e., days 9-14 post-FSH peak in urine. The sensitivity and specificity of the change in urinary FSH concentrations to detect pregnancy in a different set of 55 cycles were found to be 88.9% and 89.3%, respectively. All six cases of early fetal loss in the sample set were correctly identified. These results suggest that urinary FSH can be used as an additional biomarker for the verification of early pregnancy in prospective epidemiologic studies in which early fetal loss is a suspected outcome.
Key words
: biomarker, early fetal loss, FSH, menstrual cycles, pregnancy, spontaneous abortion.
Environ Health Perspect
105:862-866 (1997)
Address correspondence to B.L. Lasley, Institute of Toxicology and Environmental Health, University of California, Davis, CA 95616 USA.
The authors gratefully acknowledge Kathryn Sweeney for recruiting the subjects, coordinating the urine collection, and collecting the blood samples; Mona Jahwar for assisting in the FSH analysis; and James Kesner for reviewing the original manuscript. This work was supported by National Institutes of Health grants ES04699 and ES06198.
Received 21 November 1996; accepted 7 May 1997.
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Last Update: September 23, 1997
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