Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, United States.
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States.
Clin Chim Acta. 2020 Feb;501:60-65. doi: 10.1016/j.cca.2019.09.021. Epub 2019 Nov 6.
Successful outcomes of in vitro fertilization (IVF) are dependent in part on successful oocyte maturation and retrieval during a controlled ovarian stimulation process, which is guided by serial ultrasound and estradiol measurements. Yet, laboratory analysis of estradiol poses challenges due to the need for accuracy and specificity across concentrations that span multiple orders of magnitude. The Endocrine Society released a 2013 position statement that called for improvements in methods to analyze estradiol, and while some progress has been made in standardization and assay specificity, further work is needed to meet the needs of patients in both the IVF setting and in other clinical contexts. This review highlights the capabilities and challenges of current laboratory methods for the analysis of estradiol in the IVF setting, including automated immunoassays and liquid chromatography-tandem mass spectrometry, and discusses current efforts to improve the analytical sensitivity and standardization of estradiol assays. Clinical laboratorians should be aware of the limitations of current estradiol assays and select appropriate methods for the measurement of estradiol in their patient population.
体外受精（IVF）的成功结果部分取决于在控制性卵巢刺激过程中成功的卵母细胞成熟和取回，这是由连续的超声和雌二醇测量来指导的。然而，由于需要在跨越多个数量级的浓度范围内具有准确性和特异性，因此对雌二醇进行实验室分析具有挑战性。内分泌学会在 2013 年发布了一份立场声明，呼吁改进分析雌二醇的方法，虽然在标准化和测定特异性方面已经取得了一些进展，但仍需要进一步努力，以满足 IVF 环境中和其他临床环境中患者的需求。这篇综述强调了当前用于分析 IVF 环境中雌二醇的实验室方法的能力和挑战，包括自动化免疫分析和液相色谱-串联质谱法，并讨论了提高雌二醇测定分析灵敏度和标准化的当前努力。临床实验室人员应该了解当前雌二醇测定的局限性，并为其患者群体选择适当的雌二醇测量方法。
