Abstract
Liquid chromatography tandem mass spectrometry (LC-MS/MS) is becoming more widely available in clinical laboratories, allowing the development of methods that measure multiple analytes simultaneously. Moving away from traditional analysis of single analytes may have unexpected consequences, however, as we report here. An assessment of biochemical androgen status in women is commonly requested when a patient presents with clinical features of hyperandrogenism, such as hirsutism or acne, and also in the investigation of infertility. Conditions that characteristically show androgen excess include polycystic ovarian syndrome (PCOS), congenital adrenal hyperplasia (CAH), and androgen-secreting tumors (1). Our previous protocol for the assessment of androgen status in females was to measure testosterone before 2nd- and 3rd-line tests measuring sex hormone binding globulin (SHBG) to calculate the free androgen index (FAI) (2) and androstenedione, respectively. Since June 2005, an LC-MS/MS assay for the simultaneous measurement of testosterone and androstenedione in samples from women has been in …
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