Enterohepatic Recycling of Estrogen and its Relevance with Female Fertility

Enterohepatic recycling of estrogen after oral administration of 1 mg non-radioactive estriol was studied in fourteen women selected as the control subjects and ten infertile women in whom the infertility was appearing to be of endocrine origin. The extent of enterohepatic recycling of estriol ($E_3$) during the early follicular phase of menstrual cycle was assessed by monitoring during 48 h the urinary excretion of its two major metabolites i.e; estriol 16 $\alpha$-glucuronide ($E_3-16$$\alpha-G$) and estriol-3 glucuronide ($E_3$-3-G). The change in urinary level of $E_3$-3-G with respect to ($E_3-16$$\alpha-G$G was considered to reflect the extent of enterohepatic recycling of estriol. Lower values of urinary output of both metabolites in the infertile women as compared with the control subjects and the urinary excretion profile of both metabolites during 48 h after estriol ingestion reveal that the reduced extent of enterohepatic recycling could possibly be one of the factors which contribute towards the incidence of infertility in women.