Progesterone Testing Fact Sheet
Overview of the Test
The serum progesterone test can assess whether there is an increased risk of a miscarriage or ectopic pregnancy. The test can also monitor baby health during high-risk pregnancies. If progesterone levels fall in late pregnancy, this often means that there is an increased chance of pre-eclampsia.
The progesterone test is also used to check for ovulation during in-vitro fertilization (IVF), in those who may be having problems conceiving.
Evidence and Science behind the Test
Progesterone plays an important role in preparing the uterus for the implantation of a fertilized egg and the breasts for milk production. In men, progesterone appears to help produce other hormones.
The progesterone test allows doctors to assess interpret where a woman is in her menstrual cycle or pregnancy. Levels of progesterone rise when an egg is released from the ovary and remain high for four to six days afterwards. If the egg is fertilized then progesterone levels continue to rise, or if menstruation occurs, levels fall. If levels of progesterone do not rise and fall during the month, then a woman may be failing to ovulate and if levels are not rising during early pregnancy, it may be due to an ectopic or unsuccessful pregnancy. Progesterone levels are higher where twins or triplets are carried and higher levels can occasionally point to disorders such as luteal ovarian cysts.
It seems that as well as playing a vital role in pregnancy, progesterone also acts as an anti-inflammatory agent in successful pregnancies. This means that progesterone may help prevent pregnancy failures that arise because of inflammatory disorders. A number of studies have also confirmed that a single serum progesterone test is able to distinguish between successful and non-successful early pregnancies.
How is it done?
A small quantity of blood is required from the arm. On average, a woman before ovulation or a post-menopausal woman will have less than one nanogram per milliliter (ng/mL) of progesterone, whereas during the menstrual cycle, it can rise to as much as 20 ng/mL. During various pregnancy stages, levels can reach around 90 ng/mL and men have less than one ng/mL. Do be aware that different testing ranges are used, so always ask the doctor to confirm what the results actually mean.
Who Does It?
Doctor, nurse, midwife or other qualified professional.
When and How Often?
Doctors often recommend a progesterone test around one week (day 21) before menstruation commences to check for ovulation. During IVF, progesterone testing may occur more frequently especially if medications are prescribed to assist with ovulation.
Cost
If progesterone testing is part of an IVF ‘cycle’, it can cost as much as $15,000. For a single progesterone tests, prices vary from around $60 to $150, but may be covered by insurance, depending on the reason for the test.
Issues
Some medications such as birth control pills or hormone replacement therapies may need stopping before testing as these can alter results.
References
- Enzyme Immunoassay for the Quantitative Determination of Progesterone Concentration in Human Serum or Plasma: http://www.oxisresearch.com/pub/PDF/inserts/11130insert.pdf
- Ibrahim A Abdelazim, Amro Abo Elezz, and Mohamed Elsherbiny (2012). Relation between single serum progesterone assay and viability of the first trimester pregnancy. Springerplus. 2012 December; 1(1): 80.
- Aisemberg J, Vercelli CA, Bariani MV, Billi SC, Wolfson ML, Franchi AM. (2013) Progesterone Is Essential for Protecting against LPS-Induced Pregnancy Loss. LIF as a Potential Mediator of the Anti-inflammatory Effect of Progesterone. 2013;8(2):e56161. doi: 10.1371/journal.pone.0056161. Epub 2013 Feb 7.
- Serum progesterone: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004176/
- Progesterone Test: http://www.labtestsonline.org.uk/understanding/analytes/progesterone/tab/test
Last reviewed 26/Feb/2014
