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American Journal of Epidemiology Advance Access published online on October 30, 2008
American Journal of Epidemiology, doi:10.1093/aje/kwn287
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American Journal of Epidemiology Published by the Johns Hopkins Bloomberg School of Public Health 2008.

Practice of Epidemiology

Timing Clinic Visits to Phases of the Menstrual Cycle by Using a Fertility Monitor: The BioCycle Study

Penelope P. Howards, Enrique F. Schisterman, Jean Wactawski-Wende, Jennifer E. Reschke, Andrea A. Frazer and Kathleen M. Hovey

Correspondence to Dr. Penelope P. Howards, Epidemiology Department, Emory University, 1518 Clifton Road, NE, Room 450, Atlanta, GA 30322 (e-mail: penelope.howards{at}emory.edu).

Received for publication April 1, 2008. Accepted for publication August 15, 2008.

Planning study visits during specific menstrual cycle phases is important if the exposure or outcome is influenced by hormonal variation. However, hormone profiles differ across cycles and across women. The value of using fertility monitors to time clinic visits was evaluated in the BioCycle Study (2005–2007). Women aged 18–44 years (mean, 27.4) with self-reported menstrual cycle lengths of 21–35 days were recruited in Buffalo, New York, for 2 cycles (n = 250). Participants were provided with home fertility monitors that measured urinary estrone-3-glucuronide and luteinizing hormone (LH). The women were instructed to visit the clinic for a blood draw when the monitor indicated an LH surge. The monitor recorded a surge during 76% of the first cycles and 78% of the second cycles. Scheduling visits by using set cycle days or algorithms based on cycle length, such as a midcycle window or a window determined by assuming a fixed luteal phase length, would be simpler. However, even with perfect attendance in a 3-day window, these methods would have performed poorly, capturing the monitor-detected LH surge only 37%–57% of the time. Fertility monitors appear to be useful in timing clinic visits in a compliant population with flexible schedules.

hormones; menstrual cycle; ovulation detection; ovulation prediction; research design

Abbreviations: E3G, estrone-3-glucuronide; LH, luteinizing hormone; SD, standard deviation


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