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Sugammadex interference with serum progesterone measurement: an in‐vitro study

Year: 2026

Type: article

Abstract: INTRODUCTION: Sugammadex may interfere with serum progesterone immunoassays, potentially rendering measured concentrations and resulting recommendations unreliable. METHODS: . Total progesterone concentrations in each sample were determined using the routine electrochemiluminescence immunoassay method. A subgroup of 15 samples underwent further testing using liquid chromatography-tandem mass spectroscopy, comparing baseline with sugammadex 120 μM. RESULTS: Thirty-five participants provided blood samples. Increasing concentrations of sugammadex were associated with lower measured serum progesterone, with an approximate 10% reduction with each doubling of sugammadex concentration (F(2,30) = 4.86, p = 0.015). Overall, progesterone concentrations decreased by a mean (SD) of 34.6% (12.4%) between control samples and those spiked with sugammadex 120 μM (p = 0.015). In contrast, liquid chromatography-tandem mass spectroscopy showed no statistically significant biochemical change in progesterone concentrations between baseline and sugammadex 120 μM. DISCUSSION: Sugammadex produced a dose-dependent reduction in the progesterone concentrations when measured by immunoassay techniques, but not by liquid chromatography-tandem mass spectroscopy. This suggests that an immunoassay interference occurs across clinically relevant doses. Progesterone results from routine laboratory testing should be interpreted with caution in the presence of sugammadex.

Source: Anaesthesia

DOI: 10.1111/anae.70292

Authors: Tamblyn Devoy, Theresa Larkin, Miles Allan, Kevin Mantik, Monika McShane, Natalie A. Smith