Poster Presentation Annual Meetings of the Endocrine Society of Australia and Society for Reproductive Biology and Australia and New Zealand Bone and Mineral Society 2016

The improved ability to measure testosterone at lower concentrations with liquid chromatography tandem mass spectrometry may not translate to a clinical difference in women presenting with infertility (#380)

Claudia Hurwitz 1 , Sophie Hepburn 2 , Michael Wright 2 , Renee Sahertian 2 , William Ledger 3 4 , Chris White 2 3 5
  1. School of Medicine , Western Sydney University, Sydney
  2. SEALS Department of Clinical Chemistry and Endocrinology, Sydney
  3. Faculty of Medicine, University of New South Wales, Sydney
  4. Department of Obstetrics and Gynaecology, The Royal Hospital for Women, Sydney
  5. Department of Endocrinology, Prince of Wales Public Hospital, Sydney

Objective: Measuring testosterone in women is challenging due to decreased sensitivity and specificity at the lower concentrations seen in women. We compared the ability of liquid chromatography tandem mass spectrometry (LC-MS/MS) and chemiluminescent immunoassay (CLIA) to measure testosterone and differentiate between PCOS and non-PCOS women with infertility.

Design. Retrospective cross-sectional study from August 2013 to November 2014.

Patients. 26 Polycystic ovarian syndrome (PCOS) patients and 40 non-PCOS patients presenting to an infertility clinic with a stored follicular phase anti-mullerian hormone sample.

Measurements. Serum testosterone measured by CLIA (Immulite) and LCMSMS (Sciex 6500)

Results. Testosterone was significantly higher in women with PCOS than non-PCOS. Passing-Bablok regression showed CLIA = 0.22 + 0.98 LC-MS/MS (95% CI for intercept -0.08 to 0.51; slope 0.62 to 1.2. Bland-Altman analysis showed a mean percentage difference of 14% with limits of agreement of -59 and 86%. Diagnostic performance using receiver operating characteristic curves did not differ (AUC 0.77 for LC-MS/MS [95% CI; 0.66-0.89] and 0.788 for CLIA [95% CI; 0.67-0.91]

Conclusions. Measurement of testosterone by LC-MS/MS and CLIA show good agreement but a large degree of scatter at the low levels seen in women. There was minimal difference in the ability of either method to differentiate between PCOS and non-PCOS patients in this population.

Disclosure statement: The authors have nothing to disclose