Date sent: Fri, 8 Feb 2002 10:50:10 -0000
Send reply to: "Grimes, Helen, UCHG" <[log in to unmask]>
From: "Grimes, Helen, UCHG" <[log in to unmask]>
Subject: Infertility or Hirsuitism Initial Workup
To: [log in to unmask]
> We have had an increase in requests for DHEAS. Can anyone answer as to
> whether testosterone and FAI alone are the initial screen (although I find
> many FAI are somewhat elevated due to low SHBG in what maybe obese women,
> and I would query as to how clinically significant they are). What do we
> miss or gain if to this we add androstendione, or DHEAS or androstendione
> and DHEAS? We do Testosterone, SHBG, derived FAI and Androstendione.
> Dr Helen Grimes
> Department of Clinical Biochemistry
> University College Hospital
> Galway
> Ireland
I agree with Dr Wallace in that a full androgen profile is not
necessary in patients having an initial workup for hirsutism. It is our
policy to measure testosterone, SHBG and FAI on the specimen. If
the tesosterone is elevated the assay is repeated using an
extraction step as falsly high results are sometimes obtained in
females using direct assays for testosterone. We measure
androstenedione if the testosterone, after extraction, is still
elevated and DHEAS / 17 OH Progesterone if the extracted
testosterone is greater that 4.0 nmol/l.
John Kane
Hope Hospital
Salford
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