Elevated Free Androgen Index as an Indicator of Polycystic Ovaries in Oligomenorrhoea without Obesity or Hirsuties

Abstract

A group of oligomenorrhoeic women without obesity or hirsuties was investigated with high-resolution ultrasound, laparoscopy and biochemical parameters. In this series, polycystic ovaries (PCO), as defined by ultrasound and laparoscopy, are a common cause of oligomenorrhoea in women without the classic symptoms, and were strongly associated with an elevated free androgen index (FAI). Despite an elevated FAI, these women were not hirsute, It would seem reasonable to include a FAI in the investigation of the oligomenorrhoeic woman, along with the more 'standard' tests, such as thyroid function and a prolactin level.

Measurement of serum testosterone in women; what should we do?

“…The reasons for this are still unclear for most assays but certainly include inaccurate calibration in addition to the e¡ect of interfering Ann Clin Biochem 2007; 44: [5][6][7][8][9][10][11][12][13][14][15] substances. The degree of interference is not predictable in any given sample adding to the complexity of interpretation of the results.…”

“…This could potentially result in normal women having results suggestive of polycystic ovarian syndrome or a more serious condition such Ann Clin Biochem 2007; 44: [5][6][7][8][9][10][11][12][13][14][15] as an androgen-secreting tumour or late onset congenital adrenal hyperplasia. This could in turn potentially lead to unnecessary further investigations or procedures being performed on these patients.…”

“…Many laboratories also calculate the Free Androgen Index (serum testosterone Â100/SHBG) (FAI). This has been shown in some studies to be a more sensitive marker of PCOS, 5,6 although its accuracy in predicting free testosterone concentration has been questioned. 7 Measurements of free testosterone have been performed using equilibrium dialysis techniques but, being technically complex, these are not suitable for use in most laboratories.…”

“…Networks of steroid reference laboratories also exist 15 whose members exchange protocols and results so as to maintain a trueness base (established using a panel of unprocessed single donation human sera whose testosterone values have been assigned by the reference laboratories). The newly formed Joint Committee for Traceability in Laboratory Medicine (JCTLM) 16 is compiling a database of reference methods and reference materials, which can be used to assign values to calibrants and controls Ann Clin Biochem 2007; 44: [5][6][7][8][9][10][11][12][13][14][15] and thus meet the traceability requirements of the European Union In Vitro Diagnostic Devices (EU IVD) Directive. 17 Materials and methods for steroid hormones were among the ¢rst to be included in the JCTLM database.…”

Endocrine Features in Eutestosteronemic Women with Polycystic Ovaries

“…Polycystic ovaries can be induced by administration of high-dose T against intersex subjects [3]. On the other hand, certain women have PCO without obesity or hirsutism [5] and without high serum T. We therefore attempted to evaluate endocrine profile between two groups with high and normal T in the patients diag nosed as PCO by ultrasonography. In the subjects with normal T, there were no detectable differences in serum levels of LH, FSH, PRL, Ei, E2, and DHEA-S, compared with the control group, while severely suppressed SHBG level and slightly increased A concentration were ob served.…”