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HelpTest ID: PGSN Progesterone, Serum
Reporting Name
Progesterone, SUseful 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 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 specimen 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.
Report Available
Same day/1 dayDay(s) Performed
Monday through Sunday
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(6):782-7. doi:10.1016/s0022-3476(74)80340-9
2. Haymond S, Gronowski AM. In Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed. Elsevier; 2006: 2097-2152
3. CALIPER Database. The Hospital for Sick Children. Available at: https://caliperproject.ca/caliper/database/
4. Cole T. Hormones. In: Rifai N, Chiu RWK, Young I, Burnham CA, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 38
Method Name
Electrochemiluminescence Immunoassay (ECLIA)
Specimen Type
SerumSpecimen Required
Patient Preparation: For 12 hours before specimen collection, patient should not take multivitamins or dietary supplements (eg, hair, skin, and nail supplements) containing biotin (vitamin B7).
Supplies: Sarstedt Aliquot Tube 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
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 serum aliquoted into a plastic vial 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
<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
≥ 18 years: <0.20 ng/mL
Reference intervals are central 90th percentile 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
≥ 18 years:
Reference intervals are central 90th percentile 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. https://caliperproject.ca/caliper/database/
For International System of Units (SI) conversion for Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html.
Test Classification
This test has been cleared, approved, or is exempt by the US 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 |
mml-adrenal-gonad-pituitary