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Epic Test Code LAB529 Progesterone, Serum

Important Note

This test is used when DHEA interferene is suspected.

Additional Codes

MML:PGSN

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

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Specimen 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.

Day(s) Performed

Monday through Sunday

CPT Code Information

84144

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.

Cautions

Assessment of the function of the corpus luteum requires correlation with the phase of the menstrual cycle.

 

Taking estrogen and progesterone supplements can affect results.

 

As with all tests containing monoclonal mouse antibodies, erroneous findings may be obtained from specimens collected from patients who have been treated with monoclonal mouse antibodies or have received them for diagnostic purposes.

 

In rare cases, interference can occur due to extremely high titers of antibodies to ruthenium and streptavidin.

Report Available

Same day/1 day

Specimen Retention Time

7 days

Reject Due To

Gross hemolysis Reject
Gross lipemia OK

NY State Approved

Yes

Method Name

Electrochemiluminescence Immunoassay (ECLIA)