Interpretation of plasma luteinizing hormone assay for the collection of mature oocytes from women: definition of a luteinizing hormone surge-initiating rise.

Analysis of plasma luteinizing hormone (LH) assays (4 assays per day) permits the discernment of the onset of the physiologic effects of ovulatory release. This threshold value of LH plasma concentration (LH surge-initiating rise, LH SIR) is determined for each cycle in terms of the average baseline level of the previous day. The chronology of follicle and oocyte maturation after LH SIR is similar to that which follows chorionic gonadotropin (hCG) administration: none of the 20 patients, compared with 2 out of 10, had ovulated when laparoscopy was performed 30 to 35 hours and 36 to 38 hours after LH SIR time, respectively; 1 out of 3, 9 out of 14, and 5 out of 5 patients had an in vitro fertilized egg when oocytes were collected 30 to 32, 33 to 35, and 36 to 38 hours after LH SIR time, respectively. Thus the oocyte can be collected 34 to 35 hours after the LH SIR; at this point ovulation has not occurred and the oocyte is capable of being fertilized.