Salivary estradiol and progesterone levels in conception and nonconception cycles in women: Evaluation of a new assay for salivary estradiol

Objective: To determine the usefulness of salivary E₂ and progesterone for noninvasive assessment of ovarian function. Design: Prospective study of salivary hormone levels in women planning a pregnancy. Setting: Department of Obstetrics and Gynecology at Northwestern University Medical School in Chicago, Illinois. Patient(s): Fourteen women aged 23-39 years with regular menstrual cycles who were planning a pregnancy. Intervention(s): None. Main Outcome Measure(s): Salivary estradiol and progesterone concentrations. Result(s): The sensitivity of the E₂ assay is 2.0 pmol/L; the interassay coefficient of variation was 5.2% (mean value 17 pmol/L). Recovery of E₂ added to saliva was 106%. The correlation with simultaneous serum samples was 0.71. Menstrual cycle patterns contained a preovulatory depression and a midcycle surge. By comparison with nonconception cycles, the luteal phases of conception cycles had significantly elevated salivary E₂ within the first 5 days after ovulation. Salivary progesterone was significantly elevated but not until 10 days after ovulation. Conclusion(s): Salivary measurements of E₂ and progesterone can be used as noninvasive methods for assessment of ovarian function. Salivary specimens can be collected at home and brought to the laboratory for analysis, obviating the need for frequent phlebotomy. The sensitivity and precision of the salivary E₂ assay make it comparable with assays of serum E₂ for assessing changes in hormone levels.