Elevated oestradiol levels protective against OAB during ovulation induction

A sharp increase in oestrogen levels confers a protective effect on overactive bladder (OAB) symptoms in women undergoing ovulation induction, a study has found.

Researchers looked at 100 consecutive women (mean age, 36.9 years) who underwent in-vitro fertilization treatments. They used questionnaires on urinary urgency (USIQ), urinary incontinence (MESA) and lower urinary tract symptoms (BFLUTS-SF) to evaluate OAB symptoms before ovulation induction (low oestradiol level) and prior to ovum pickup (peak oestradiol level).

Forty-nine women had OAB symptoms prior to ovulation induction (mean USIQ severity score, 33), whereas 51 women were asymptomatic. In the symptomatic group, 44 women (90 percent) remained symptomatic (mean USIQ severity score, 34), while five became asymptomatic through ovulation induction.

In the asymptomatic group, on the other hand, 24 women (47 percent) developed OAB symptoms, while 27 (53 percent) remained asymptomatic through ovulation induction. Women who remained asymptomatic had significantly higher mean peak oestradiol levels compared with those who had de novo OAB symptoms (2,069 vs 1,372 pg/ml).

Notably, peak oestradiol levels were >1,500 pg/ml in 63 percent of women who remained asymptomatic but were <1,500 pg/ml in 67 percent of those who became symptomatic.

The present data underscore the possibility of a threshold for oestradiol activity in the lower urinary tract, the researchers said. More studies are warranted to evaluate the efficacy of the various oestrogen preparations and the best treatment modality for OAB symptoms.