Progesterone

CPT Test code: 84144

Specimen:	Serum
Volume:	0.8 mL
Minimum Volume:	0.3 mL (Note: This volume does not allow for repeat testing.)
Container:	Red-top tube or gel-barrier tube
Collection:	If a red-top tube is used, transfer separated serum to a plastic transport tube.
Storage Instructions:	Refrigerate
Reference Interval:	Male: 0.2-1.4 ng/mL Female: • Follicular: 0.2-1.5 ng/mL • Luteal: 1.7-27.0 ng/mL • Ovulation: 0.8-3.0 ng/mL • Pregnant: − First trimester: 8.8- 48.6 ng/mL − Second trimester: 12.4-75.8 ng/mL − Third trimester: 58.5-222.3 ng/mL • Postmenopausal: 0.1-0.8 ng/mL
Use:	Establish the presence of a functioning corpus luteum or luteal cell function; confirm basal body temperature measurements for the occurrence of ovulation; obtain an indication of the day of ovulation; evaluate the functional state of the corpus luteum in infertility patients; assess placental function during pregnancy; ovarian function test
Limitations:	In patients receiving therapy with high biotin doses (ie, >5 mg/day), no sample should be taken until at least eight hours after the last biotin administration.¹ As with all tests containing monoclonal mouse antibodies, erroneous findings may be obtained from samples taken from patients who have been treated with monoclonal mouse antibodies or who have received them for diagnostic purposes.¹ In rare cases, interference due to extremely high titers of antibodies to streptavidin and ruthenium can occur.¹ The test contains additives that minimize these effects.
Additional Information:	Progesterone is a steroid hormone with a molecular weight of 314.5 daltons.² Progesterone is mainly formed in the cells of the corpus luteum and during pregnancy in the placenta. Progesterone is increased in congenital adrenal hyperplasia due to 21-hydroxylase, 17-hydroxylase, and 11-β-hydroxylase deficiency. Progesterone is decreased in primary or secondary hypogonadism and short luteal phase syndrome. The progesterone concentration correlates with the development and regression of the corpus luteum. Whereas progesterone is barely detectable in the follicular phase of the female cycle, a rise in the progesterone level is observed one day prior to ovulation. Increased progesterone synthesis occurs during the luteal phase. In the second half of the cycle pregnanediol is excreted in urine as the main degradation product of progesterone. Progesterone brings about the conversion of the uterine mucosa into a tissue rich in glands (secretion phase), in order to prepare for the intrauterine implantation of the fertilized ovum. During pregnancy, progesterone inhibits the contraction of the myometrium. In the mammary gland, progesterone (together with estrogens) promotes the proliferation and secretion disposition of the alveoli.^2,3 The determination of progesterone is utilized in fertility diagnosis for the detection of ovulation and assessment of the luteal phase.^3,4
Footnotes:	1. Progesterone on Elecsys 1010/2010 and Modular Analytics E170, package insert 2007-09, V 11, Indianapolis, IN: Roche Diagnostics, 2007. 2. Johnson MR, Carter G, Grint C, et al, “Relationship Between Ovarian Steroids, Gonadotrophins and Relaxin During the Menstrual Cycle,” Acta Endocrinol, 1993, 129(2):121-5.PubMed 8372595 3. Runnebaum B, Rabe T, “Gynäkologische Endokrinologie und Fortpflanzungsmedizin,” Springer Verlag 1994, Band 1: 36-8, 70, 116; Band 2: 137, 360, 398-9, 408-9, 422-3. 4. Guillaume J, Benjamin F, Sicuranza B, et al, “Maternal Serum Levels of Estradiol, Progesterone and Human Chorionic Gonadotropin in Ectopic Pregnancy and Their Correlation With Endometrial Histologic Findings,” Surg Gynecol Obstet, 1987, 165(1):9-12.PubMed 3589936
References:	Hilborn S, Krahn J, “Effect of Time of Exposure of Serum to Gel-Barrier Tubes on Results for Progesterone and Some Other Endocrine Tests,” Clin Chem, 1987, 33(1):203-4. PubMed 3802491 Nippoldt TB, Reame NE, Kelch RP, et al, “The Roles of Estradiol and Progesterone in Decreasing Luteinizing Hormone Pulse Frequency in the Luteal Phase of the Menstrual Cycle,” J Clin Endocrinol Metab, 1989, 69(1):67-76. PubMed 2499593 Rebar RW, “The Ovaries,” Cecil Textbook of Medicine, 18th ed, Volume 2, Wyngaarden JB, Smith LH Jr, eds, Philadelphia, PA: WB Saunders Co, 1988, 1425-46. Romero R, Scoccia B, Mazor M, et al, “Evidence for a Local Change in the Progesterone/Estrogen Ratio in Human Parturition at Term,” Am J Obstet Gynecol, 1988, 159(3):657-60. PubMed 2971319 Stewart MO, Whittaker PG, Persson B, et al, “A Longitudinal Study of Circulating Progesterone, Oestradiol, hCG and hPL During Pregnancy in Type 1 Diabetic Mothers,” Br J Obstet Gynaecol, 1989, 96(4):415-23.PubMed 2751954