[Screening for incomplete enzymatic blocks of 21-hydroxylase. Study of 17-OH progesterone with tetracosactide in the follicular and luteal phases in hirsute women].

It seemed to us worth while when taking plasma samples to prove the presence or absence of ovulation and the presence or absence of a 21-hydroxylase block by estimating the levels of 17-hydroxyprogesterone under stimulation with tetracosactide. The results are as delta hydroxyprogesterone (ng/dl/mn). Eighteen women were studied in this way in the follicular phase (delta OHP: 1.21 +/- 0.71 ng/dl/mn) and 9 women in the luteal phase (delta OHP: 0.76 +/- 0.55 ng/dl/mn). This, while reliable, was not significant statistically. The explanation seems to be linked to anovulation. In the five cases with anovulation delta OHP was 0.233 ng/dl/mn, while in other cases where ovulation was proved to exist it was 1 ng/dl/mn. It seems to us that the so-called "luteal phase" should not have been retained when we wanted to test for a hormonal block, except where ovulation has been proved previously to be present, because of the possibility of anovulation. The interrelationships between the polycystic ovary syndrome and the therapeutic implications are discussed.