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Test ID: PGSN Progesterone, Serum

Reporting Name

Progesterone, S

Useful For

Ascertaining whether ovulation occurred in a menstrual cycle

 

Assessment of infertility

 

Evaluation of abnormal uterine bleeding

 

Evaluation of placental health in high-risk pregnancy

 

Determining the effectiveness of progesterone injections when administered to women to help support early pregnancy

 

Workup of some patients with adrenal disorders

Clinical Information

Sources of progesterone are the adrenal glands, corpus luteum, and placenta.

 

Adrenal Glands:

Progesterone synthesized in the adrenal glands is converted to other corticosteroids and androgens and, thus, is not a major contributor to circulating serum levels unless there is a progesterone-producing tumor present.

 

Corpus Luteum:

After ovulation, there is a significant rise in serum levels as the corpus luteum begins to produce progesterone in increasing amounts. This causes changes in the uterus, preparing it for implantation of a fertilized egg. If implantation occurs, the trophoblast begins to secrete human chorionic gonadotropin, which maintains the corpus luteum and its secretion of progesterone. If there is no implantation, the corpus luteum degenerates and circulating progesterone levels decrease rapidly, reaching follicular phase levels about 4 days before the next menstrual period.

 

Placenta:

By the end of the first trimester, the placenta becomes the primary secretor of progesterone.

Interpretation

Ovulation results in a midcycle surge of luteinizing hormone (LH) followed by an increase in progesterone secretion, peaking between day 21 and 23. If no fertilization and implantation has occurred by then, supplying the corpus luteum with human chorionic gonadotropin-driven growth stimulus, progesterone secretion falls, ultimately triggering menstruation. Typically, day 21 to 23 serum progesterone concentrations of more than 10 ng/mL indicate normal ovulation and concentrations below 10 ng/mL suggest anovulation, inadequate luteal phase progesterone production, or inappropriate timing of sample collection.

 

Increased progesterone concentrations are occasionally seen with some ovarian cysts, molar pregnancies, rare forms of ovarian cancer, adrenal cancer, congenital adrenal hyperplasia, and testicular tumors. Increased progesterone may also be a result of overproduction by the adrenal glands.   

 

Low concentrations of progesterone may be associated with toxemia in late pregnancy, decreased ovarian function, amenorrhea, ectopic pregnancy, and miscarriage.

Analytic Time

Same day/1 day

Day(s) and Time(s) Performed

Monday through Sunday; Continuously

Clinical Reference

1. Lippe BM, LaFranchi SH, Lavin N, et al: Serum 17-alpha-hydroxyprogesterone, progesterone, estradiol, and testosterone in the diagnosis and management of congenital adrenal hyperplasia. J Pediatr 1974;85:782-787

2. Haymond S, Gronowski AM: In Tietz Textbook of Clinical Chemistry and Molecular  Diagnostics. Fourth edition. Edited by CA Burtis, ER Ashwood, DE Bruns. St. Louis, Elsevier, Inc, 2006, pp 2097-2152

3. CALIPER Database. The Hospital for Sick Children. Toronto, Canada. Available at: www.sickkids.ca/caliperproject/index.html

Method Name

Electrochemiluminescence Immunoassay

Specimen Type

Serum


Specimen Required


Patient Preparation: For 12 hours before specimen collection do not take multivitamins or dietary supplements containing biotin (vitamin B7), which is commonly found in hair, skin, and nail supplements and multivitamins.

Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 1 mL

Collection Instructions:

1. Serum gel tubes should be centrifuged within 2 hours of collection.

2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Frozen (preferred) 180 days
  Refrigerated  72 hours
  Ambient  8 hours

Reference Values

Males:

<4 weeks: Not established

4 weeks-<12 months: ≤0.66 ng/mL (confidence interval 0.63-0.94 ng/mL)

12 months-9 years: ≤0.35 ng/mL

10-17 years: Concentrations increase through adolescence and puberty

12 months-9 years: ≤0.35 ng/mL

≥ 18 years (central 90th %): <0.20 ng/mL

≥ 18 years: <0.20 ng/mL (Reference intervals are central 90th % of healthy population)

 

Females:

<4 days old: Not established

4 days-<12 months: ≤1.3 ng/mL (confidence interval 0.88-2.3 ng/mL)

12 months-9 years: ≤0.35 ng/mL

10-17 years: Adult concentrations are attained by puberty

12 months-9 years: ≤0.35 ng/mL

Adult (central 90th %):

-Follicular phase: ≤0.89 ng/mL

-Ovulation: ≤12 ng/mL

-Luteal phase: 1.8-24 ng/mL

--Pregnancy

---1st trimester: 11-44 ng/mL

---2nd trimester: 25-83 ng/mL

---3rd trimester: 58-214 ng/mL

≥ 18 years:

Reference intervals are central 90th % of healthy population

-Follicular phase: ≤0.89 ng/mL

-Ovulation: ≤12 ng/mL

-Luteal phase: 1.8-24 ng/mL

-Post-menopausal: ≤0.20 ng/mL

--Pregnancy

---1st trimester: 11-44 ng/mL

---2nd trimester: 25-83 ng/mL

---3rd trimester: 58-214 ng/mL

 

Pediatric reference intervals adopted from the CALIPER study. www.sickkids.ca/caliperproject/index.html The Hospital for Sick Children. Toronto, Canada.

 

For SI unit Reference Values, see https://www.mayocliniclabs.com/order-tests/si-unit-conversion.html

Test Classification

This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

84144

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PGSN Progesterone, S 83109-9

 

Result ID Test Result Name Result LOINC Value
PGSN Progesterone, S 83109-9
Mayo Clinic Laboratories | Endocrinology Catalog Additional Information:

mml-adrenal-gonad-pituitary