[Enzymatic determination of urinary estrogens. A 5-year experience in a hospital milieu].

The enzymatic method for urinary estrogens determination from Nicolas et al. has become a useful tool for the management of infertility problems. It can be used for: investigation of ovarian by establishing the urinary estrogens profile during menstrual cycle, useful to: understand anomalies of the spontaneous cycle, explain some therapeutic failures during IVF attempts or artificial inseminations (AID or AIC); prediction of failures during IVF attempts during spontaneous cycles, and monitoring ovarian response during stimulated cycles in order to determine the trigger with hCG; monitoring ovulation during induction of ovulation in anovulatory patients stimulated with various drugs (clomiphene citrate, pure FSH combination of FSH and LH, GnRH ou analogs...) under various conditions of prescription and administration (oral, IM, intermittent pulsatile administration with portable pump with or without hypophyseal down regulation). This technique allows also exploration of androgens after changing main androgens (delta 4 A, T, DHEA, DHEA S) into estrogens through the action of placental aromatase, as well as appreciation of aromatase activity of some tissues in the presence of androgenic substrates. This paper gives the conclusions after 5 years of practice with this method and summaries different works published by the biologists who developed the method and by the clinicians who used its results.