ORGANIZATIONAL AND ECONOMIC ASPECTS OF IMPLEMENTING GENDER VERIFICATION METHODS IN HIGH-LEVEL SPORTS
Organizational and economic aspects of implementing gender verification methods in high-level sports belong to controversial issues since they are concerned with the selection of methods for identifying the corresponding genetic characteristics of the human body. From the perspective of geneticists, endocrinologists and other medical workers, their implementation has long been criticized. To determine the prospects of using genetic achievements for gender verification in high-level sports, the authors of the article have considered the role of genetic information in the sports of the highest achievements and possible correction of borderline conditions; analyzed the methods used from the viewpoint of their reliability; assessed the costs of such genetic studies and examined their organization in the context of determining a competent subject and standardizing techniques and procedures. In contrast to the previous practice of gender verification, the current studies focus on changing testosterone levels and utilize different methods, some of which determine the level of total testosterone and the others define the level of free testosterone. Based on expert estimates, the authors have concluded that the method of tandem mass spectrometry is the most effective. Since the International Association of Athletics Federations allows the medical treatment of testosterone levels as a condition for admission to international competitions, the ongoing studies cannot be limited to identifying its quantitative indicators. An additional objective is to reveal the causes of hyperandrogenism, i.e. to expand the list of the methods used whose application should be unified with due regard to modern medical advances. From the economic viewpoint, measuring testosterone levels is not expensive but the costs will inevitably increase 10-15 times for identifying the causes of hormonal imbalances.
Chen, Y., Yazdanpanah, M., Wang, X.Y., Barry, R., Hoffman, B.R., Eleftherios, P., Diamandis, E.P. & Wong, P.Y. Direct measurement of serum free testosterone by ultrafiltration followed by liquid chromatography tandem mass spectrometry. Clinical Biochemistry. 2010. 43. Р. 490-496.
Dadachanji, R., Shaikh, N., Mukherjee, S. Genetic Variants Associated with Hyperandrogenemia in PCOS Pathophysiology. Genetics Research International. 2018. URL: https://doi.org/10.1155/2018/7624932/.
Dickinson, B.D., Genel, M., Robinowitz, C.B., Turner, P.L., Woods, G.L. Gender verification of female Olympic athletes // Medicine & Science in Sports & Exercise. 2002. Vol. 34. Issue 10. P. 1539-1542.
Fiet, J., Giton, F., Fidaa, I., Valleix, A., Galons, H. & Raynaud, J.P. Development of a highly sensitive and specific new testosterone time-resolved fluoroimmunoassay in human serum. Steroids 2004. 69. P. 461-471.
Goodarzi, M.O, Carmina, E. & Azziz, R. DHEA, DHEAS and PCOS. Journal of Steroid Biochemistry and Molecular Biology. 2015. 145. Р. 213-225.
Heinrich-Balard, L., Zeinyeh, W., Déchaud, H., Rivory, P., Roux, A., Pugeat, M. & Cohen, R. Inverse relationship between hSHBG affinity for testosterone and hSHBG concentration revealed by surface plasmon resonance. Molecular and Cellular Endocrinology. 2015. 399. Р. 201-207.
Keevil, B.G. Novel liquid chromatography tandem mass spectrometry (LC–MS/MS) methods for measuring steroids. Best Practice Research Clinical Endocrinology and Metabolism. 2013. 27. Р. 663-674.
Martínez-Patiño, M.J., Mateos-Padorno, C., Martínez-Vidal, A., Sánchez, A.M., García, J.L., Díaz, M.P., Touriño, C.F. An approach to the biological, historical and psychological repercussions of gender verification in top level competitions // Journal of Human Sport & Exercise. 2010. Vol. 5. Issue 3. P. 307-321.
Piketty, M.P, Prie, D., Sedel, F., Bernard, D., Hercend, C., Chanson, P.H. & Souberbielle, J.C. High-dose biotin therapy leading to false biochemical endocrine profiles: validation of a simple method to overcome biotin interference. Clinical Chemistry Laboratory Medicine. 2017. 55. Р. 817-835.
Pugeat, M., Dechaud, H., Raverot, V., Denuziere, A., Cohen, R. & Boudou, P. Recommendations for investigation of hyperandrogenism. Annals of Endocrinology 2010. 71. P. 2-7.
Pugeat, M., Plotton, I., de la Perrière, A.B., Raverot, G., Déchaud, H., Raverot, V. Hyperandrogenic states in women: pitfalls in laboratory diagnosis // European Journal of Endocrinology. 2018. 178, Р. 141-154.
Rupert, L. James Genitals to Genes: The History and Biology of Gender Verification in the Olympics. CBMH/BCHM. Vol. 28: 2. 2011. P. 339-365.
Stanczyk, F.Z. Diagnosis of hyperandrogenism: biochemical criteria. Best Practice and Research Clinical Endocrinology and Metabolism. 2006. 20. Р. 177-191.
Goncharov, N.P., Katsiya, G.V. Sovremennye metody opredeleniya testosterone [Modern methods of measuring testosterone] // Vestnik reproduktivnogo zdorovya. 2008. 7. P. 31-37.
Ivashkina, S.G. Testosteron - vozmozhnosti laboratorii [Testosterone and laboratory capabilities] // Meditsinskii alfavit. Laboratornaya diagnostika. 2007. 7. P. 40-43.
Konenkov, N.V., Makhmudov, M.N., Stepanov, V.A. Tendentsii razvitiya kvadrupolnoi mass-spektrometrii [Trends for developing quadrupole mass spectrometry] // Vestnik Ryazanskogo gosudarstvennogo universiteta im. S.A. Esenina. 2007. 3(16). P. 98-112.
Malysheva, N.M. Svobodnye biologicheski aktivnye formy testosterona kak naibolee adekvatnye markery dlya otsenki androgennogo statusa [Free biologically active forms of testosterone as the most adequate markers for assessing androgenous status]: an extended abstract thesis for a Candidate Degree in Law Sciences. Moscow, 2009. P. 12.
Nikonova, L.V., Tishkovskii, S.V., Butrim, O.S., Davydchik, E.V. Kliniko-gormonalnye varianty sindroma giperandrogenii [Clinical and medical variants of hyperandrogenism] // Journal of the Grodno State Medical University. 2018. Vol. 16, 5. P. 542-548