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Methods for evaluating reproductive health of women.

The use of urine as a practical sample for evaluating the reproductive health of women in population-based studies is still being developed and applied. The adaptation of enzyme-based assays for the assessment of ovarian steroids as well as simple computer algorithms for interpreting the data both simplify and increase the efficiency of modern reproductive epidemiologic studies. New statistical approaches and new assays have extended physiologic monitoring to include early pregnancy, luteal phase function, and ovulation. While urine is superior to blood sampling, it is important to remember, however, the limitations of urinary hormone measurements when applying them alone to identify specific types of reproductive failure because variations in metabolism and excretion rate still contribute some uncontrollable variation. The rate of progress in developing and refining these methods over the past 5 years indicates that urinary methods of reproductive monitoring will continue to dominate this field and eventually be used in the clinic as well.