Ultra-Sensitive LC-MS/MS Method for Progesterone Quantification in Serum: Establishing Reference Intervals in Men

madman

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* Mean progesterone was 170 pmol/L, with 2nd and 97.5th percentiles were 71 and 316 pmol/L, respectively.






Introduction

Progesterone is a steroid hormone commonly measured during assessment of female ovarian function. However, there is a lack of validated methods with the sensitivity to quantitate progesterone at concentrations found in males, post-menopausal females or patients on steroid hormone lowering medications. Here, we aimed to develop a high sensitivity LC-MS/MS method for this purpose. We also applied this method to derive a reference interval in a male cohort.


Methods

The method was developed on a Waters TQ-XS mass spectrometer. Calibrators and quality controls were gravimetrically prepared from separate stocks of certified reference material. The method utilised a 96-well plate format, with a progesterone-2,3,4-13C3 internal standard. Extraction was performed using supported liquid extraction with MTBE. Male samples (n = 52), collected between 8 – 10 AM from patients aged 25 - 81, were retrieved prior to disposal, anonymised and analysed.

Results

Progesterone and its internal standard eluted with a symmetrical peak at 3.3 minutes. Concentrations ranging from 25 to 54000 pmol/l could be quantitated. The method demonstrated good recovery and minimal matrix effects. Male samples (n = 19) were excluded from the reference interval (n =14 due to medications that may cause adrenal suppression, n = 5 due to outlying progesterone concentrations). Mean progesterone was 170 pmol/L, with 2nd and 97.5th percentiles were 71 and 316 pmol/L, respectively.


Conclusions

We present a high sensitivity LC-MS/MS method to measure serum progesterone. This may benefit clinical applications such as assessment of infertility or breast cancer risk in post-menopausal women. We have also applied this method to derive a male reference interval for progesterone.
 

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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