WHAT IS DUTCH CYCLE MAPPING™?

For some women, testing reproductive hormones (progesterone, estrogen, etc.) on a single day is sufficient. In other scenarios, the clinical picture cannot be properly captured without “mapping” out the hormonal pattern throughout their menstrual cycle.

The expected pattern of hormones shows relatively low estrogen levels early in the cycle, a surge around ovulation and modest levels in the latter third of the cycle (the luteal phase). Progesterone levels, on the other hand, stay relatively low until after ovulation. After ovulation, levels ideally increase (>10-fold) and then drop back down at the end of the cycle. A disruption in this cycle can lead to infertility or hormonal imbalance.

WHEN IS DUTCH CYCLE MAPPING™ RECOMMENDED?

• Women struggling with infertility
• Women with cycling hormones and no menses
• Partial hysterectomy (ovaries intact but no uterus)
• Ablations
• Mirena IUD (no actual menstrual bleeding due to IUD but still has hormonal symptoms)
• Women with irregular cycles
• PCOS
• If the luteal phase shifts from month-to-month
• Not sure when to test due to long or short cycles
• Women whose hormonal symptoms tend to fluctuate throughout the cycle
• PMS, mid-cycle spotting, migraines, etc.

WHEN IS DUTCH CYCLE MAPPING™ NOT NEEDED? (DUTCH COMPLETE™ IS SUFFICIENT)

• Postmenopausal women
• Women on birth control
• Women with cycles that follow the expected pattern

MOST CONVENIENT METHOD FOR MONTH-LONG ANALYSIS

EASY SAMPLE COLLECTIONS MAKE FOR BETTER TESTING

Salivary mapping of hormones limits the number of collections, which may result in missing progesterone and especially estrogen peaks if not timed correctly. For women with irregular cycles, this is particularly problematic. DUTCH Cycle Mapping™ uses more sample collections (convenient, first-morning urine collections) and performs testing on targeted samples based on the actual length of the cycle. This allows for better characterization of both the ovulatory and luteal peaks

BETTER TESTING MAKES FOR BETTER TREATMENT

Treating women appropriately and effectively with irregular cycles, fertility problems, or who have had an ablation can be challenging to practitioners because it is difficult to fully ascertain what their hormones are doing and when. By using the DUTCH Cycle Mapping™ test, a complete picture of the patient’s cycle in graph format will allow for a more accurate and comprehensive treatment program specific to the patient’s situation. The clinician can understand if and when a patient is ovulating. They can also determine why their patients are having mid-cycle spotting or hormonal migraines. This will help them get a clear understanding of how their patient’s ovaries are functioning or look further into fertility issues. These answers will help with the clinician’s goal of individualized medicine.

HOW WELL DO ESTROGEN AND PROGESTERONE VALUES CORRELATE WITH SERUM MEASUREMENTS?

Hormone patterns throughout the menstrual cycle parallel simultaneously collected serum samples very well. When compared to salivary measurements, DUTCH measurements showed improved correlation to serum for both progesterone and especially for estradiol.

DO DRIED SAMPLES COMPROMISE THE ANALYSIS?

Dried samples are accurate for hormone testing, and values correlate to liquid samples (see graph, below). Samples are more stable once they are dried and also much easier to store and ship than liquid samples.

You will be collecting a series of samples throughout the course of one menstrual cycle. View cycle mapping collection video at dutchtest.com/videos/sample-collection for assistance.

Let’s Get Started

You will use only one schedule (on pages 3, 5, 7) and ignore the others.

Which schedule should I use?

Simply Answer: How long is your typical cycle?

Cycling:

• Day 1 of your cycle should be considered the first day with menstrual flow (not just spotting). Collection will begin on the seventh day of your cycle.
• The Last 4 Samples #22–#25 will be collected on the fourth day after your next cycle start date.

Non Cycling: (Functional ovaries without regular menstrual bleeding)

• Start collections any day. Collect your samples directly upon waking on the days listed.
• To keep track of the 25 samples, fill in the date of collection on your schedule AND on each urine collection device.

NOTE: It is typically required to discontinue any estrogen, progesterone, or pregnenolone ! supplementation.

How to Collect

1. Complete all information on each urine collection device. Fill in the day of cycle and date of collection with pen (not a gel pen).

2. Saturate the filter paper by urinating directly on it OR urinating into a clean cup and dip the filter paper for 5 seconds.
3. Leave each sample open to dry for at least 24 hours.
4. Once dry, close each collection device and conveniently store in the kit box until you are done collecting all samples.
5. Continue collecting according to your schedule. Once ALL samples are completely dry, place them in the enclosed plastic bag and seal.

Note: If you miss a collection simply collect the following day and continue the schedule as listed. Cut around the dotted line and return this chart with your samples.

How to Return

• Cut out the completed collection schedule and return with your dried urine collection devices and requisition. Return the sealed plastic bag and completed paperwork in the enclosed return envelope.
• (8 stamps minimum will be required for postage.)

For more instructions, click here.