A pilot study on the utility of reduced urine collection frequency protocols for the assessment of reproductive hormones in adolescent girls

Background: The objectives of this study were to assess the feasibility of and compliance to collecting urine samples in pre- and postmenarcheal girls and to determine if a less than daily collection frequency was sufficient for assessing ovarian function. Methods: Twenty-five postmenarcheal girls (11-17 years) collected samples using either a two or a three samples/week protocol during one menstrual cycle. Exposure and mean estrone-1-glucuronide (E1G) and pregnanediol glucuronide concentrations were calculated, and evidence of luteal activity (ELA) was evaluated. Sixteen premenarcheal girls (8-11 years) collected one sample/month for six consecutive months. Samples were analyzed for E1G concentration. Participant compliance was calculated using dates on the urine samples and paper calendars. Results: Participants collecting three samples/week were more compliant to the protocol than those collecting two samples/week (83.6% +/- 2.6% vs. 66.8% +/- 6.6%; p = 0.034). There were no differences (p > 0.10) regarding paper calendar return (81.8% +/- 12.2% vs. 92.9% +/- 7.1%), recording menses (55.6% +/- 17.6% vs. 92.3% +/- 7.7%) or sample collection (88.9% +/- 11.1% vs. 84.6% +/- 10.4%) between the two protocols. The average cycle length was 30.5 +/- 1.3 days and 32% of cycles had ELA. The premenarcheal girls were 100% compliant to the protocol. Only 68.8% of participants returned the paper calendar and 81.8% of those participants recorded sample collection. The average E1G concentration was 15.9 +/- 3.8 ng/mL. Conclusions: Use of a less than daily collection frequency during one menstrual cycle in postmenarcheal, adolescent girls is feasible and provides informative data about ovarian function. Collection of one sample/month in premenarcheal girls is feasible and detects the expected low E1G concentrations. Alternate strategies to the use of a paper calendar should be considered.