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Progesterone

What is the progesterone-immunoassay test?

Progesterone-immunoassay is a test carried out for the testing progesterone level in blood. Secretion of C21 steroid hormones by corpus luteum after ovulation during the menstrual cycles stimulates the production of progesterone hormones (major female sex hormones). They are responsible for the reproduction-related activity, breast glandular development, the endometrial aspects of menstrual cycles, and the establishment and maintenance of pregnancy. If pregnancy is conceived, progesterone is secreted by the placenta for embedding and continuation of early pregnancy. Serum progesterone quantification is carried out to detect the gluteal phase and validate recent ovulation. There is increasing use of serum progesterone in the follicular phase to ferret out premature luteinization while in vitro fertilization (IVF) hyper-stimulation. 

Gonadotropin-releasing hormones (GRH) analogs in IVF are used in controlled ovarian hyper-stimulation, for the suppression of pituitary gonadotropin secretion, and inclusive of prevention of surge of a premature luteinizing hormone (LH). Progesterone levels are usually low during the follicular stage of menstrual cycles. After ovulation, progesterone levels increase for about 5 days before going back down. If pregnancy is conceived, progesterone levels will gradually rise from the ninth week of pregnancy to the thirty-second week.

What is progesterone-immunoassay used for?

Progesterone Immunoassay is used to calculate progesterone concentration in human blood serum. Progesterone-immunoassay is carried out to:

  • Find out the reasons behind not conceiving pregnancy even after a lot of tries
  • Check the time for ovulation
  • Check whether there is a high risk of miscarriage during pregnancy
  • Ectopic pregnancy diagnosis
  • High a risk pregnancy monitoring
  • To identify the cause of infertility in females
  • It is useful in predicting non-viable pregnancies in women with pain or bleeding when ultrasound results come out to be inconclusive.

Why and when do you need to get a Progesterone immunoassay?

When there is trouble getting pregnant, you may need to carry out a progesterone- immunoassay; the test will help the health care provider estimate the ovulation tracking. During pregnancy, progesterone immunoassay is used to detect the health of the pregnancy and pregnancy-related complications like bleeding, cramps, and placental abruption and to indicate whether you are at risk of miscarriage or not.

What kind of sample is required?

For progesterone immunoassay, a simple blood sample will be required. The doctor will take your blood sample by himself or send you to another site, where your blood will be taken.  Blood will be drawn from the vein by first cleaning the site then inserting a needle in the vein. It will be collected in a tube and sent to a laboratory for further tests.

Do you need to prepare for the test?

There is no specific need to be prepared for progesterone immunoassay. You need to tell your healthcare provider the last date of your menstrual cycle. Make sure your doctor knows all about the medicines, herbs, vitamins, and supplements you are using, including unprescribed medicines and illegal drugs you may be using. Certain blood thinners may cause complications; your health care provider may ask you to stop this medication before doing the test.

Are there any risks to this test?

There are no such risk factors related to progesterone immunoassay. However, some risks may come with the needle used for drawing blood. These include bruising, infection, or bleeding. You may experience a slight sting feeling when the needle pricks your arm afterward, and the site may be sore.

What does the test result mean?

Serum progesterone levels are measured in nanograms per deciliter (NG/DL). Results may vary depending on age, gender, menstrual cycle, and pregnancy. For women who menstruate, their blood progesterone level fluctuates, i.e., low at the beginning of each menstrual cycle, at a peak after ovulation, and again fall back to a low level unless the pregnancy is conceived.

Reference Ranges:

Males: 

  • Lower than 1.4 NG/mL

Females:

  • In follicular phase lower than 1.0 NG/mL
  • In luteal phase lower than 2.6-21.5 NG/mL
  • During postmenopausal lower than 0.5 NG/mL

Pregnancy Range:

  • During the first trimester, 4.1-34.0 NG/DL
  • During the second trimester, 24.0-76.0 NG/mL
  • During the third trimester, 52.0-302.0 NG/mL

Normal test results:

In the normal test, progesterone level falls between:

  • Men, postmenopausal females, and females at the beginning of the menstrual cycles, 1 ng/m.
  • Females in the middle of their menstruation 5-20 NG/mL
  • Pregnant women during 1st trimester 11.2-90 NG/mL
  • Pregnant women during 2nd trimester 25.6-89.4 NG/mL
  • Pregnant women during 3rd trimester 48.5-42.5 NG/mL

Abnormal test results:

The test result level does not between normal ranges is considered abnormal test results. The progesterone level can be too high or too low.

High progesterone level

High progesterone levels can be caused by:

  • Ovarian cancer
  • Congenital adrenal hyperplasia
  • Adrenal cancer

Low progesterone level

Low progesterone levels may be due to:

  • Absence of periods
  • Miscarriage
  • Fetal death
  • Ectopic pregnancy
  • Abnormal/ absence of ovulation

Related test:

Estrogen level test, follicle-stimulating Hormones (FSH) levels test, Luteinizing Hormones (LH) level tests, pregnancy tests, Prolactin levels, SHBG blood tests, ultrasound, urine test,

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