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Hormone Testing at Clinical Labs

Hormone Testing at Clinical Labs

Written by A/Prof Mirette Saad.

INSULIN-LIKE GROWTH FACTOR-1 (IGF-1)

  • IGF-1, also referred to as somatomedin-C (Sm-C), is a hormone similar in molecular structure to insulin that is mainly produced by the liver in blood. IGF-1 mediates most of the effects of Growth Hormone (GH). It plays an important role in childhood growth and continues to have anabolic effects in adults
  • IGF-1 is produced throughout life. The highest rates of IGF-1 production occur during the pubertal growth spurt. The lowest levels occur in infancy and old age.
  • Levels of IGF-1 can vary in the circulation depending on variation in the levels of GH, insulin levels, genetic make-up, the time of day, age, sex, exercise status, stress levels, nutrition level and body mass index (BMI), disease state, ethnicity, estrogen status and xenobiotic intake.

WHY DO WE MEASURE IGF-1?
  • IGF-1: is a clinical severity marker. It correlates with GH levels in the blood so it can be a useful marker in the diagnosis of clinical conditions such as acromegaly and GH deficiency.
  • IGF-1 can also be useful in assessing patients’ nutritional status, dwarfism, and in monitoring patients on treatment for the above conditions or patients on treatment with recombinant IGF-1.

IGF-1 TEST
  • IGF-1 test is a Medicare rebateable
  • Can be performed on serum or heparinised plasma samples
  • IGF1 test is performed on Siemens Immulite® XPI. Validated Age specific Reference Ranges apply.
  • Results are available to clinicians within 2-3 business days.

ANTI-MÜLLERIAN HORMONE PLUS (AMH PLUS):

As part of the wide range of reproductive pathology services, Australian Clinical Labs has been offering the Anti-Müllerian Hormone (AMH) test using a fully automated Roche Cobas Elecsys® assay which shows excellent analytical performance over other methods including precision, accuracy and functional sensitivity. AMH is an established biomarker produced by antral and pre-antral follicles for assessing ovarian reserve which is considered an important tool in assessing potential fertility.


WHAT’S NEW?

Australian Clinical Labs has introduced the new precise, reliable and robust AMH Plus Immunoassay from Roche Cobas Elecsys®. AMH PLUS enables clinicians to use results when dosing in women undergoing an assisted reproductive technology programme with the human recombinant follicle stimulating hormone (human rFSH), REKOVELLE® (follitropin delta). AMH Age-Specific Reference Ranges (10th-90th percentile) are reported as provided by Roche.


AMH PLUS:

The test is performed on a gel serum tube and clinicians will receive full report of AMH with age specific reference ranges within 2-4 business days. This service is not rebateable by Medicare, and therefore will attract an out of pocket fee.

References:

Anderson RA, Anckaert E, Bosch E, et al. Prospective study into the value of the automated Elecsys antimüllerian hormone assay for theassessment of the ovarian growing follicle pool. Fertil Steril. 2015;103(4):1074–80.e4.

Deeks ED. Elecsys® AMH assay: a review in anti-Müllerian hormone quantification and assessment of ovarian reserve. Mol Diagn Ther 2015; 19: 245-249.

Gassner D, Jung R. First fully automated immunoassay for anti-Müllerian hormone. Clin Chem Lab Med. 2014;52(8):1143-52.

Giustina A, et al., (2014). Nat Rev Endocrinol. 10 (4): 243–8.

Hernandez R (July 2016). Pharm Tech.

Hyldgaard J, Bor P, Ingerslev HJ, et al. Comparison of two different methods for measuring anti-mullerian hormone in a clinical series.Reprod Biol Endocrinol. 2015 Sep 22;13(1):107.

Nelson SM, Pastuszek E, Kloss G, et al. Two new automated, compared with two enzyme-linked immunosorbent antimüllerian hormone assays. Fertil Steril. 2015 Oct;104(4):1016-1021.e6.

Roche Diagnostics. Elecsys® AMH (anti-Mullerian hormone): Method sheet. 2015. https://pim-eservices.roche.com. Last accessed Novemober 2016.

Rosenbloom AL (2007). Curr. Opin. Pediatr. 19 (4): 458–64.

Sattler FR (August 2013). Best Pract. Res. Clin. Endocrinol. Metab. 27 (4): 541–55.

Scarth JP (2006). A review". Xenobiotica. 36 (2–3): 119–218.

Siemens Ref. IMC 18-November 2017

Wade N (17 February 2011). New York Times.