Dehydroepiandrosterone (DHEA) supplementation results in supraphysiologic DHEA-S serum levels and progesterone assay interference that may impact clinical management in IVF
| Autor: | Richard T. Scott, Susan Ng, Maria Fano, Eric J. Forman, Andrew A. Ruiz, Semara A. Thomas, Jason M. Franasiak |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
endocrine system medicine.medical_specialty medicine.medical_treatment Population Dehydroepiandrosterone Stimulation Serum progesterone Fertilization in Vitro Assay interference 03 medical and health sciences 0302 clinical medicine Ovulation Induction Internal medicine polycyclic compounds Genetics medicine Humans skin and connective tissue diseases education Genetics (clinical) Progesterone Immunoassay education.field_of_study 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Obstetrics and Gynecology General Medicine 030104 developmental biology Endocrinology Reproductive Medicine Sex steroid Ovulation induction Female Erratum business human activities hormones hormone substitutes and hormone antagonists Developmental Biology |
| Zdroj: | Journal of assisted reproduction and genetics. 33(3) |
| ISSN: | 1573-7330 |
| Popis: | Dehydroepiandrosterone (DHEA) is often prescribed for poor responders in IVF in an effort to improve response to ovarian stimulation. The effect of DHEA supplementation and resultant supraphysiologic DHEA-S serum levels on sex steroid assays has not been evaluated in this population. This study seeks to determine the relationship between DHEA supplementation and progesterone measurements to characterize the degree of interference with particular immunoassays.Characterization was accomplished in two phases. First, DHEA-S standard control reagents with no progesterone present were assayed for both DHEA-S and progesterone levels. Second, serum pools from 60 unique IVF patients' serum were used to create six pooled serum samples: three from patients on DHEA supplementation and three from patients not on DHEA supplementation. The three pools were composed of patients whose serum fell into low, medium, and high progesterone ranges. Baseline DHEA-S and progesterone were measured, and the mean level of DHEA-S in the mid-range progesterone pool was used as the mid-point for addition of DHEA-S standard to the serum pools from patients without DHEA supplementation. Progesterone from these pools was then measured on three commercially available immunoassay systems.The first experiment revealed a linear increase in progesterone when analyzing the DHEA-S standard ranging from 0.5 μg/dL [corrected] in the blank control (no DHEA-S) to up to 2.0 μg/dL [corrected] in the high control (DHEA-S700 μg/dL), [corrected] indicating that the DHEA-S cross-reacts with the progesterone assays. In the second experiment, patients' serum DHEA-S and progesterone were measured from pooled serum samples of those taking DHEA and those not taking DHEA. Adding DHEA-S to the pooled serum of those not taking DHEA resulted in a linear increase in progesterone levels on two of three commercially available immunoassays (p0.05).DHEA-S can interfere with standard progesterone immunoassays used in clinical ART programs, and thus serum progesterone levels in IVF patients on DHEA supplementation may not reflect truly bioactive progesterone. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink