To the Editor:
After reading the article “Relationships between the luteinizing hormone surge and other characteristics of the menstrual cycle in normally ovulating women” (1), now including concurrent ultrasound data I would like to confirm once more hormonal findings published in Fertility and Sterility more than a decade ago (2). Unnoticed, Park et al. also described these LH patterns in your journal in 2007 (3).
I have reanalyzed the data published originally (2), according to the methods specified in the studies by Direito et al. and Park et al. (1, 3), and shown data from all three studies in Tables 1 and 2. The sum (25%) of what was first described as two peaks and a small peak (2) would be comparable herein to a double peak. Park et al. found a luteinizing hormone (LH) surge of rapid onset (within 1 day) in 42.9% of patients, and of gradual onset (in 2 to 6 days) in 57.1%, or 25.6% and 74.4% in 2 to 10 days, respectively. Overall, although in some cases there seemed to be a tendency, after analyzing three or more cycles from each woman, I did not clearly find repetition of the same type of LH profile within the same woman reported by Direito et al. Relating LH and Pregnanediol Glucuronide (PDG) profiles, a novel finding is that cases with double- and multiple-peaked LH surges associated significantly with transient rises in PDG before the definite rise (P<0.001, Chi test; PDG rise according to Park et al.). Read the rest of this entry »