17 he progesterone ifa. Laboratory diagnostics

Before donating blood for progesterone, preparation is important. Hormone levels can be affected by diet, stress, sexual contact, as well as bad habits and medications. All this should be excluded for the time being.

Why are women prescribed a blood test for progesterone levels?

A progesterone test is of great importance for determining the hormonal status of a woman planning a pregnancy. Progesterone is a female sex hormone. It prepares the uterus for the movement of a fertilized egg and the attachment of the fetus, being the key to a successful pregnancy. In addition, it adapts the pregnant woman’s nervous system to this period and to the birth of a child, helps the development of the mammary glands and the production of milk in them.

The concentration of the hormone increases rapidly during the ovulation phase until the follicle bursts and the egg is released. Next, the follicle transforms into the corpus luteum. The level of progesterone increases when the body is ready for the process of conceiving a child.

The amount of progesterone changes cyclically. It is observed when natural physiological processes occur, but it can also be the result of pathologies.

If the amount of progesterone increases sharply, this may indicate the following conditions:

• current pregnancy;
• the presence of a corpus luteum cyst;
• hydatidiform moles;
• failure of the kidneys and adrenal glands;
• malignant tumors;
• infertility;
• cirrhosis;
• obesity.

Some pathologies cause an increase in progesterone already in an advanced state, with long-term development, so such a symptom should under no circumstances be ignored.

If the hormone level has changed downward, this may mean the following:

• threat of abortion due to hormonal imbalances;
• likelihood of miscarriage;
• lack of ovulation;
• disturbance in the menstrual cycle;
• the appearance of severe bleeding from the vagina.

If a woman notices such symptoms, she needs to urgently consult a doctor, be examined and undergo the necessary tests.

A deviation in progesterone levels from the norm in men also means that not everything is in order in the body. Its increase is associated with infertility, testicular dysfunction, decreased libido and metabolic disorders.

Symptoms of high progesterone

Symptoms and signs of elevation may vary. They depend on the individual characteristics of the body, the general health of the patient and the degree of deviation from the norm. Typically the signs are expressed as follows:

• depressed state;
• constant fatigue;
• low blood pressure;
• painful sensations in the abdomen;
• absence of menstruation;
• headaches;
• obesity.

A similar clinical picture is possible with other disorders, therefore it is necessary to establish the exact cause of poor health. To do this, of course, you will need to undergo an examination. However, if pregnancy is confirmed, then such signs are normal.

Hormone functions

The adrenal glands and the corpus luteum of the ovaries synthesize the hormone progesterone. Under its influence, the endometrium is prepared to receive the embryo. The hormone is characterized by increased activity in the luteal phase, when the corpus luteum forms in the ovaries, which produces it. The body prepares for pregnancy, and if it does not, menstruation begins. The corpus luteum disappears without fertilization, and accordingly, the concentration of progesterone immediately decreases, whereas during conception its level increases tenfold.

The functions of the hormone are as follows:

• preparing the endometrium of the uterus for a new cycle or pregnancy;
• proliferation of the mucous layer of the fallopian tubes;
• auxiliary value in preparation for lactation;
• influence on the development of all organs of the child;
• suppression of the mother's immunity to prevent fetal rejection.

Progesterone is necessary for regular menstruation without disturbances and for the safe bearing of a child. It also participates in the intrauterine maturation of the baby. In addition, the hormone protects against mastopathy and also affects the breasts, or rather, their development.

Blood test for progesterone

Poor health, disrupted cycles, heavy menstrual periods and can warn of hormonal imbalance. You should definitely go to an endocrinologist or gynecologist-endocrinologist.

After a general examination, the woman is usually sent to a laboratory to donate blood for hormone levels. The decoding of the analysis, the results of which show progesterone differs from the norm, should be carried out by a doctor. He will evaluate not only this indicator, but the entire clinical picture as a whole.

Preparation

How to submit? It is recommended to do this on day 22 of the cycle. If you have irregular periods, it is best to consult a specialist. Typically, venous blood is donated after ovulation. To obtain accurate data on the time of egg maturation, you need to do an appropriate test.

When a woman is recommended to undergo a progesterone test, the doctor should tell her how to take it and how many days in advance to start preparing. Blood is always donated on an empty stomach after an eight-hour fast. It is noteworthy that this rule also applies to pregnant women.

How to prepare for the procedure? All medications are temporarily discontinued. The use of hormonal contraceptives is also prohibited. If medications cannot be discontinued due to general health, then their names and dosage should be indicated. This will help you know the result more accurately. Two days before donating blood, it is important to avoid sex, physical activity and stress.

If you suspect pregnancy, it is advisable to check the result again with a standard test. If it is confirmed, you should check with your doctor whether it is advisable to undergo the test.

You cannot donate blood after ultrasound, radiography, or fluorography procedures.

Determination of progesterone concentration is carried out using the enzyme-linked immunosorbent assay (ELISA). It is considered quite accurate. You can donate blood at any clinic; for this it is important to take a coupon or sign up in advance so that you don’t have to stand in line. Typically, several studies are carried out over the entire cycle, since the level of the hormone is very variable.

Analysis results

Based on the results of the progesterone test, which are obtained within an hour after donating blood, the gynecologist will accurately indicate the content and determine the period of pregnancy, if any. The attending physician must decipher the examination data and interpret their results, since he has complete data on the state of health, medical history, and the results of other examinations of his patient.

The follicular phase is characterized by 0.32-2.23 nmol/liter. During ovulation, the content changes and falls within the range from 0.48 to 9.41 nmol/liter. The luteal phase is marked by the highest values ​​- from 7.02 to 57 nmol/liter.

Normal values ​​vary greatly at different periods of the cycle and depend on the stage of pregnancy. When carrying a child, progesterone increases tens and hundreds of times. If the test does not reveal this during the expected pregnancy, it is better to retake it.

When progesterone levels suddenly drop, there is a risk of miscarriage.

In addition, a decrease in this hormone is manifested by a delay in intrauterine development of the child, diagnosed with postterm pregnancy, insufficient functioning of the placenta and corpus luteum, and inflammatory processes. Low progesterone levels during pregnancy are dangerous because they can cause hypoxia or lack of oxygen in the child, poor fetal development, and premature birth.

Experts, taking into account the results of laboratory diagnostics, can prescribe certain medications to replenish hormone levels in a certain period of the cycle or even during pregnancy.

Conclusion

Testing for the hormone progesterone is very important, especially for pregnant women. It provides body functions associated with childbirth, so its quantity must be carefully monitored to prevent the development of pathologies in the woman and the unborn child.

httpss://youtu.be/-aX6-5fKl8Y

We recommend similar articles

Price: on request

You can add an item to your cart by specifying the quantity

Manufacturer: Hema-medica

Country: Russia

Unit Meas.: set

Type of packaging: cardboard box

Article: K217

Description

Quantitative determination of progesterone concentration in blood serum (plasma) using enzyme-linked immunosorbent assay

Functional purpose

The determination of progesterone is based on the use of a competitive enzyme immunoassay. Mouse monoclonal antibodies to progesterone are immobilized on the inner surface of the wells of the plate. Progesterone from the sample competes with conjugated progesterone to bind to antibodies on the surface of the well. The result is a plastic-bound “sandwich” containing peroxidase. During incubation with a solution of tetramethylbenzidine (TMB) substrate, the solutions in the wells become colored. The color intensity is inversely proportional to the concentration of progesterone in the test sample. The concentration of progesterone in the test samples is determined using a calibration graph of the dependence of optical density on the progesterone content in calibration samples

Specifications

Method: enzyme-linked immunosorbent assay.
Sample: serum, blood plasma.
Specificity 100%.
Sensitivity: the minimum reliably detectable concentration does not exceed 0.5 nmol/l.
The coefficient of variation of the results does not exceed 8%.
Linearity: in the concentration range 1-300 nmol/l ± 10%.
The kit is designed for analysis in duplicate of 40 test samples, 7 calibration samples and 1 control serum sample (96 determinations in total).
Set contents:
1. 96-well polystyrene plate, stripped, ready to use - 1 pc.
2. Calibration samples based on human blood serum containing known amounts of progesterone - 0; 1; 3; 10; 30; 100; 300 nmol/l, ready to use (calibration sample 0 nmol/l - 2 ml, the rest - 0.8 ml each) transparent purple liquids (calibration sample 0 - transparent colorless liquid) - 7 pcs.
3. Control serum based on human blood serum with known progesterone content, ready to use, clear, colorless liquid, 0.8 ml x 1 bottle.
4. Conjugate, ready to use, clear purple liquid, 22 ml x 1 bottle.
5. Tetramethylbenzidine (TMB) substrate solution, ready to use, clear, colorless liquid, 11 ml x 1 bottle.
6. Cleaning solution concentrate, 21x, transparent colorless liquid, 22 ml x 1 bottle.
7. Stop reagent, ready to use, clear, colorless liquid, 11 ml x 1 bottle.
8. Paper for gluing the tablet - 2 pcs.
9. Instructions for use - 1 pc.
10. Quality control certificate - 1 pc.
Store the kit at a temperature of +2...+8 °C throughout the expiration date indicated on the packaging; freezing is not allowed. Store the prepared cleaning solution at room temperature (+18…+25 °C) for no more than 5 days or at a temperature of +2…+8 °C for no more than 30 days. Once opened, the calibration serum is good for 2 months.
The optical density value is measured at a wavelength of 450 nm.
Registered with Roszdravnadzor.

17-OH-progesterone is produced by the adrenal glands and is one of the regulators of sexual function and the menstrual cycle, affecting the ability to conceive and bear a child. Under normal conditions, its level in the blood is insignificant, and in the female body it is subject to significant fluctuations due to the menstrual cycle and pregnancy.

In the first phase of the cycle, 17-OH-progesterone is secreted by the ovaries in a small amount; by the middle of the cycle, its level increases slightly and remains unchanged throughout the second phase.

If fertilization and implantation of the embryo has occurred, the level of the hormone will begin to increase gradually, but if conception has not occurred, the value of 17-OH-progesterone will again decrease to a minimum at the beginning of a new phase of the cycle.

When is a test ordered?

Sometimes, if hormonal imbalances or hyperplasia (overgrowth) of the adrenal cortex are suspected, a blood test is prescribed to measure the level of 17-OH-progesterone.

This usually happens when:

• infertility in women with signs of hirsutism (increased body hair),
• for menstrual irregularities,
• if adrenal tumors are suspected.
• Sometimes a blood test is prescribed for children with suspected congenital adrenal hyperplasia (adrenogenital syndrome).

How the analysis is carried out

For women, a test for the level of 17-OH-progesterone is carried out in the first phase of the cycle, 3-5 days after the start of menstruation. Children are tested any day, in the morning, on an empty stomach.

Normal 17-OH-PG values ​​What do the results mean?

There may be three analysis options:

The level of 17-OH-progesterone is normal.

This means that hormonal abnormalities are not associated with the adrenal cortex or ovaries,

The hormone level is increased.

Hormone levels may increase with tumors of the ovary or adrenal glands.

Mild forms of hormone elevation usually result in menstrual irregularities and infertility.

An increase in the level of 17-OH-progesterone occurs with congenital adrenal hyperplasia in children and adults.

In children, this is usually a genetically determined pathology, transmitted in an autosomal recessive manner as a defect in one of the enzymes that allows hormones to be actively metabolized. As a result of a failure in this chain, testosterone synthesis and accumulation occurs. At birth, signs of virilization are revealed - an increase in male sexual characteristics in boys, with an enlargement of the penis and scrotum; in girls - signs of false hermaphrditism - an increase in the clitoris and labia, mistakenly taken for the penis and scrotum. Children of both sexes also develop metabolic disorders with severe losses of potassium and sodium salts.

The level of 17-OH-progesterone is reduced.

This condition occurs with Addison's disease, congenital or acquired adrenal insufficiency. In addition, a decrease in the level of the hormone in men occurs in a state of false hermaphroditism - when the synthesis of progesterone is disrupted and because of this, the normal formation of the body according to the male type is disrupted.

General information about the hormone

17-OH-progesterone or hydroxyprogesterone is one of the intermediate products of hormone metabolism that belongs to the group of steroids.

It is formed from two precursors - progesterone and 17-hydroxypregnenolone, through complex transformations in the adrenal glands into the hormone cortisol.

Hydroxyprogesterone can also be produced in the placenta and genitals, where it is also converted into androstenedione (this substance is the starting point for the synthesis of either the male sex hormone testosterone or the female sex hormone -

ELISA studies:

Laboratory diagnosis of reproductive system disorders (part 2)

Nechaev V.N., Ph.D.

Determination of prolactin levels

The first stage of laboratory examination of persons of both sexes suffering from reproductive disorders, according to WHO recommendations, is to measure the concentration of prolactin (milk hormone) in the blood serum (plasma). Prolactin does not directly affect the functional activity of the gonads, while at the same time the level of prolactin in the blood clearly correlates with the state of the hypothalamus and adenohypophysis. Prolactin regulates milk secretion during lactation. Prolactin is a hormone antagonist of FSH and LH, and with increased production of prolactin, the hormonal function of the ovaries is disrupted and a hyperprolactinemic form of infertility occurs. Physiological hyperprolactinemia is observed in women who are breastfeeding. In non-breastfeeding women, elevated prolactin levels may be associated with certain medications, a tumor of the pituitary gland, or a malfunction of the pituitary gland. One of the manifestations of hyperprolactinemia is the release of colostrum or milk from the mammary glands, especially in nulliparous women. Pathological changes in the body, with increased or decreased levels of prolactin, are presented in Table 1.

Table 1. Pathological changes in the body with increased or decreased levels of prolactin

Prolactin is found in the blood serum in three different forms. The biologically and immunologically active monomeric form predominates (approximately 80%), 5-20% is present as a dimeric inactive form and 0.5-5% is present as a tetrameric, also inactive form. Table 2 presents reference values ​​for the concentrations of the monomeric form (biologically active) of prolactin.

Table 2. Reference values ​​for serum prolactin concentrations

Indications for determination:

Women of childbearing period:

• Menstrual irregularities and amenorrhea
• Infertility
• Lactation disorders
• Galactorrhea
• Pituitary hyperfunction syndrome
• Pituitary insufficiency

• Testicular failure
• Azoospermia, oligospermia
• Galactorrhea
• Pituitary hyperfunction syndrome
• Pituitary insufficiency
• Replacement therapy after removal of a pituitary tumor

Preparing samples for analysis

Prolactin has a fairly pronounced circadian rhythm with the maximum release of the hormone during night sleep. It is recommended to take blood sampling in the morning (8-10 hours), in the early follicular phase of the cycle (in women with a regular cycle) and in a calm environment. To exclude an accidental increase in prolactin levels in response to stress (blood drawing), a 2-3-fold study is desirable.

Material for research:

• blood serum

FSH and LH are the “main” hormones of reproduction

If determining the level of prolactin in the blood provides information about the functional state of the hypothalamic-pituitary complex as a whole, then to assess the activity of the reproductive system, measuring the content of gonadotropic hormones in the blood - FSH and LH - is used.

It is these hormones that ensure the growth and development of follicles (FSH) and stimulate the synthesis of sex hormones in the gonads (LH). The secretion of LH and FSH is, in turn, under the control of gonadal sex hormones (negative feedback mechanism). An increase in the level of sex hormones, primarily estradiol, in the blood is accompanied by inhibition of the secretion of gonadotropins (and vice versa). FSH secretion is additionally regulated by inhibin, a polypeptide synthesized by the gonads. During the preovulatory period, the mature dominant follicle secretes large amounts of estradiol into the blood, under the influence of which an ovulatory release of LH and FSH occurs (a positive feedback phenomenon). This rise (ovulatory peak) lasts very briefly, 1-2 days. The intensity of gonadotropin secretion during the periovulatory period determines the future functional activity of the corpus luteum. The daily (circadian) rhythm of secretion of LH and FSH in adults is not pronounced, unlike in adolescents, while the circhoral (hourly) rhythm of secretion is very characteristic of gonadotropins.

Modern ELISA test systems for the determination of FSH and LH are based on the use of monoclonal antibodies that do not cross-react with the closely related hormones TSH and hCG.

Table 3. Reference values ​​for FSH and LH concentrations in blood serum.

Preparing samples for analysis

Gonadotropin levels do not follow a circadian rhythm and there is no need to draw blood in a fasting state. It should be borne in mind that with a preserved menstrual cycle, a single determination of gonadotropins can be performed only in the early follicular phase (days 6-8 of the cycle). More clear results are obtained by taking 2-3 blood samples with an interval of 30-40 minutes and then combining the resulting sera. LH and FSH cannot be determined once in a blood sample taken in the middle of the cycle to detect ovulation. The timing of ovulation for cycles of different lengths is different (about 14 days before the start of the expected menstruation) and can shift by 1-2 days from the expected ones. In this regard, the results of a single determination of gonadotropins on the 13-14th days of the cycle in most cases provide false information about the nature of the cycle. The pulsatile nature of secretion at intervals of 1-2 hours is especially characteristic of PH, so the results of single tests should be considered approximate. Serum or plasma samples after clot formation and/or red blood cell separation are stable for a time sufficient to allow samples to be mailed. Frozen samples can be stored for long periods of time.

Blood must be collected with a wide bore needle, by gravity flow, or with slight negative pressure from the syringe piston.

Material for research:

• blood serum
• heparinized blood plasma

Determination of sex hormones

There is no doubt that for a complete examination of the state of the reproductive system, it is necessary to have ELISA test systems for determining sex hormones (estradiol, testosterone, progesterone) in blood serum. If the synthesis of sex hormones in the gonads is sharply reduced, then, through a negative feedback mechanism, the secretion of gonadotropins increases sharply so that the diagnosis of lack of ovarian function does not cause difficulties.

In the diagnostic algorithm of examination for suspected endocrine infertility, the key is to determine the concentrations of LH, FSH, estradiol and testosterone.

Methods for determining these hormones today are predominantly based on enzyme-linked immunosorbent or immunofluorescent technology, which ensures their widespread use.

Estradiol

Estradiol is the main estrogenic steroid hormone. Catabolism in the liver leads to the transformation of estradiol into estriol or into glucuronides and sulfates excreted in the urine.

In women, estradiol is synthesized and secreted in the ovaries, in the membrane and granulosa cells of the follicles. It stimulates the development of the first phase of the ovarian cycle, causing an increase in uterine muscle protein and endometrial hyperplasia. At the pituitary level, it also acts on the secretion of LH, FSH. During the first phase of the cycle, an increasing increase in estradiol concentration leads to massive secretion of LH, which “triggers ovulation.” During pregnancy, the concentration of estradiol increases. Plasma estradiol analysis is a key parameter in monitoring ovulation induction and ovarian stimulation. The increase in the rate of estradiol synthesis and its concentration at the end of stimulation reflects the number and quality of maturing follicles.

Table 4. Reference values ​​for estradiol concentrations in blood serum.

Indications for determination:

• control of stimulated ovulation,
• assessment of ovarian function,
• menstrual irregularities,
• amenorrhea of ​​hypothalamic origin,
• estrogen-producing tumors
• monitoring of infertility treatment,
• osteoporosis;

men:

• gynecomastia,

children:

• monitoring the progress of puberty.

Table 5. Diseases and conditions in which the concentration of estradiol in the blood serum may change

Progesterone

Progesterone is one of the main steroid hormones. It is secreted in small quantities by the cells of the corpus luteum of the ovaries in the luteal phase of the menstrual cycle. It acts on the endometrium together with estradiol, as a result of which the menstrual cycle passes from the proliferative phase to the secretory phase. Progesterone levels reach their maximum on the 5th - 7th day after ovulation. If fertilization does not occur, progesterone levels decrease, and conversely, if fertilization does occur, the corpus luteum continues to secrete large amounts of progesterone until 12 weeks of pregnancy. Then the placenta comes into play, which becomes the main site of hormone production. Progesterone is also secreted in small quantities by the adrenal cortex and testes and is an intermediate in the synthesis of androgens.

In the blood, progesterone is found both in free and bound to protein carriers (albumin and transcortin) states. The half-life of the hormone is several minutes, two-thirds of progesterone is metabolized in the liver and secreted into the urine as free pregnanediol, pregnanediol glucuronide and pregnanediol sulfate.

Table 6. Reference values ​​for progesterone concentration in blood serum

Indications for determination:

women :

• ovulation disorders,
• absence of ovulation with or without oligomenorrhea,
• insufficiency of corpus luteum function;
• accurate determination of ovulation
• induction of ovulation by human menopausal gonadotropin or clomiphene (both in the presence of hCG and without it);
• confirmation of ovulation (determination in the second half of the cycle);
• monitoring the progress of ovulation in women who have undergone spontaneous abortion;

men and children:

• defect in steroid biosynthesis.

Progesterone causes an increase in basal body temperature. In case of diagnosis of insufficiency of corpus luteum function, samples are taken 3 times (each after 3-4 days of the previous collection). In at least 2 cases, the progesterone concentration should exceed 10 μg/ml.

Testosterone

In women, testosterone is formed in the adrenal cortex and ovaries in a 1:1 ratio and serves as a substrate for the formation of estrogens, and also stimulates the preovulatory release of LH. Testosterone levels do not change with age in women. Normal testosterone levels in women are 0 - 0.9 ng/ml.

Indications for determination:

• Klinefelter syndrome and other chromosomal diseases;
• hypopituitarism;
• enzymatic disorders of androgen synthesis;
• hirsutism and virilization of women;
• most androgen-producing tumors of the ovaries and kidneys.

In women, it is also necessary to determine the level of DHEA - sulfate, which has an effect similar to testosterone (in men it is an auxiliary agent in the study of testosterone).

Material for research:

• blood serum of women on days 3-7 of the menstrual cycle, preferably between 8 and 10 am.

Steroid binding globulin (SBG) in blood serum

SSG is a protein that binds and transports testosterone and estradiol. In addition to its transport function, DES protects testosterone and estradiol from metabolic activity along the way from the gland secreting them to the target organ, and forms a kind of hormone depot in the body. SSG is an acidic glycoprotein with a molecular weight of 45,000 daltons. Violation of the synthesis of dry hormones leads to disruption of the delivery of hormones to target organs and the performance of their functional activity. The concentration of dry hormones in the blood serum is increased by estrogens and oral contraceptives, and decreased by androgens, T4, and TSH.

Table 7. Reference values ​​for dry serum concentrations

Precursors for the biosynthesis of androgens and estrogens

17α-Hydroxyprogesterone

17a-Hydroxyprogesterone (17OH-P) is an intermediate steroid in the biosynthesis of glucocorticoids, androgens and estrogens, which is synthesized from progesterone and 17a-hydroxypregnenolone. Secreted by the adrenal cortex, ovaries and testes, it circulates in the blood, both in free and bound, like progesterone, with two proteins - albumin and transcortin. The half-life of 17OH-P is several minutes. It is metabolized by the liver and excreted in the urine as pregnanetriol.

17OH-P is produced in small quantities by the ovaries during the follicular phase, then its concentration increases and remains constant during the luteal phase. If fertilization does not occur, the level of 17OH-P decreases. When a fertilized egg is implanted, the corpus luteum continues to secrete 17OH-P.

Analysis of 17OH-P is very important for the diagnosis of congenital adrenal hyperplasia and detection of enzyme deficiency responsible for the occurrence of this disease.

The level of 17OH-P in the blood is particularly indicative and is critical in the diagnosis of 21-hydroxylase deficiency in newborns.

In adulthood, with partial or late-onset enzyme deficiency, the basic level of 17OH-P activity may be normal or increased

Table 8. Reference values ​​for 17OH-P concentration in blood serum

Indications for determination:

• congenital enzyme deficiency responsible for the occurrence of adrenal hyperplasia;
• diseases associated with 21-hydroxylase deficiency in newborns (high levels of 17OH-P);
• partially or late manifested deficiency of 21-hydroxylase (normal or high level of 17OH-P);
• differential diagnosis of infertility.

Material for research:

• blood serum;

Dehydroepiandrosterone

Dehydroepiandrosterone (DHEA) is one of the most important androgens (more precisely, their precursor), synthesized by the adrenal cortex and gonads from 17OH-R. It is catabolized into the virilizing androgens: androstenediol, testosterone and dihydrotestosterone.

Most DHEA is modified by adding a sulfate to (DHEA-S), which is biologically inactive, but removing the sulfate group restores the activity of DHEA. DHEA is actually a prohormone, has a shorter half-life and a higher metabolic rate, due to which its concentration in the blood is 300 times lower than the level of DHEA-S.

DHEA is characterized by a circadian level of secretion with maximum release of the hormone in the morning hours. There are no significant changes in its concentration during the menstrual cycle. Unlike testosterone, DHEA in the circulation is not associated with DES, so changes in the concentration of binding proteins do not affect its levels.

Table 9. Reference values ​​for DHEA concentrations in blood serum

Indications for determination:

• hirsutism;
• virilization;
• delayed puberty

Material for research:

• blood serum;
• blood plasma with the addition of heparin.

Dehydroepiandrosterone sulfate

DHEA-S is synthesized in the adrenal glands (95%) and ovaries (5%), excreted in the urine and constitutes the main fraction of 17a-ketosteroids. Determination of DHEA-S concentration in blood serum replaces the study of 17a-ketosteroids in urine.

DHEA-S is secreted at a rate of 10-20 mg/24 hours (35-70 µmol/24 hours) in men and 3.5-10 mg/24 hours (12-35 µmol/24 hours) in women, and without circadian rhythm. It does not bind to specific plasma proteins and, therefore, their concentration does not affect the level of DHEA-S. However, DHEA-S binds to serum albumin.

In addition to DHEA-S, DHEA is present in the circulating blood, accounting for ¼ and ½ the rate of DHEA-S secretion in men and women, respectively. Due to its high concentration of DHEA-S in the blood, long half-life and high stability, and because its source is primarily from the adrenal glands, DHEA-S is an excellent indicator of androgen secretion.

If women have elevated testosterone levels, then by determining the concentration of DHEA-S, it is possible to determine whether this is due to impaired adrenal function or ovarian disease.

Table 10. Reference values ​​for DHEA-S concentrations in blood serum

Age	Concentration (µg/ml)	Concentration (µmol/l)
Newborns.
Adults:
Pregnancy period
Premenopausal period
Postmenopausal period

Conversion factors:

• 1 ng/100ml = 28.8 nmol/l;
• 1 nmol/l = 2.6 ng/ml
• 1 ng/ml = 368.46 µmol/l

Indications for determination:

• adrenal tumors;
• differential diagnosis of ovarian diseases;
• osteoporosis;
• delayed puberty.

Material for research:

• blood serum;
• blood plasma with the addition of heparin.

Autoimmune diseases of the reproductive system

Physiological depletion of ovarian follicles in women occurs at the age of 45-55 years. Cessation of ovarian function before age 40 indicates a condition known as premature ovarian failure. The consequence of this disease is infertility. In some cases, the cause of this may be an autoimmune process associated with the formation of antibodies to ovarian sex hormones.

In some cases, the development of infertility in men is caused by the presence of specific antibodies in the serum or seminal plasma.

Ovarian antibodies in blood serum

Normally, a woman’s blood serum contains no ovarian antibodies. Ovarian antibodies (to ovarian antigens) have been detected in women with premature menopause, infertility, and in vitro fertilization. These antibodies can be produced by Leydig cells, granucile cells of the ovary and cells of the placenta. To determine antibodies to sex hormones, the method of indirect immunofluorescence and ELISA is used. The ELISA method allows you to determine both total and antibodies to various classes of immunoglobulins (IgG, IgM, IgA). Autoimmune antibodies can be detected in the blood of women many years before the development of clinical manifestations of premature ovarian failure.

In addition to ovarian antibodies, the ELISA method allows you to detect antibodies to the transparent membrane of the oocyte - total and antibodies to classes (IgG, IgM, IgA), which have the same diagnostic value as ovarian antibodies.

In women, a clear correlation between serum antibody concentrations and fertility prognosis is usually not possible.

Antisperm antibodies in blood serum

Normally, a woman’s blood serum contains no antisperm antibodies. In men, antisperm antibodies are formed as a result of an autoimmune reaction to the sperm epithelium. The reason for the development of such a reaction may be testicular trauma, bacterial and viral infections, or surgical operations on the testicle. To determine antisperm antibodies, the ELISA method is currently used, which is highly sensitive and specific, and also allows the quantitative determination of antibodies of various classes of immunoglobulins (IgG, IgM, IgA), which allows one to assess the severity and severity of the autoimmune process. In addition, in men, the concentration of antisperm antibodies correlates with the restoration of fertilization ability.

Women do not normally produce antibodies against sperm antitags, but various etiological factors (infections, autoimmune diseases) can lead to loss of immunological tolerance. If antisperm antibodies are present in a woman’s blood, then the processes of trophoblast formation, growth and formation of the placenta, and implantation are disrupted. And this leads to termination of pregnancy, gestosis, delayed fetal development, and fetoplacental insufficiency.

Testing for antisperm antibodies is recommended for all couples with unexplained infertility.

Chorionic gonadotropin (hCG) in blood serum

HCG is a glycoprotein with a molecular weight of approximately 46,000, consisting of two subunits - alpha and beta. Elevated levels of hCG in the blood serum are detected already on the 8-12th day after conception. During the first trimester of pregnancy, the concentration of hCG increases rapidly, doubling every 2-3 days. The maximum concentration occurs in the 7-10th weeks of pregnancy, after which the concentration of hCG begins to decrease and remains more or less stable during the second half of pregnancy.

Table 12. Median hCG concentration values ​​for screening congenital malformations of the fetus in the 2nd and 3rd trimester

Alpha Fetoprotein (AFP) in serum

AFP is a glycoprotein with a molecular weight of approximately 65,000 kDa, secreted by the fetal liver and yolk sac. AFP in the fetus is the main serum protein; in adults, the content of AFP in the blood serum is insignificant. In the second trimester of pregnancy, if the fetus has Down syndrome, the concentration of AFP is reduced, and the concentration of hCG in the blood is increased. Taking this into account, ELISA testing for AFP and hCG is used as a method of mass prenatal examination of pregnant women, with which it is possible to identify a high-risk group based on the presence of malformations or Down syndrome in the fetus. The median values ​​of AFP concentration in blood serum for screening of congenital malformations of the fetus in the second trimester are shown in Table 13.

Table 13. Median AFP concentrations for screening congenital malformations of the fetus in the second trimester

Free estriol in blood serum

Estriol is the main steroid hormone synthesized by the placenta. The content of estriol in the blood of a pregnant woman correlates with the activity of the fetal adrenal glands. Estriol penetrates into the bloodstream of a pregnant woman, where its concentration in the free state can be determined. During a normally developing pregnancy, estriol synthesis increases in accordance with increasing gestational age and fetal growth (Table 14).

Table 14. Concentrations of estriol in a woman’s blood serum during physiological pregnancy

Gestation period, week	Median estriol concentration, nmol/l	Reference values ​​of estriol, nmol/l

In case of pathology (severe developmental defects of the central nervous system in the fetus, congenital heart defects, Down syndrome, fetal growth restriction, fetal adrenal hypoplasia, intrauterine fetal death), the concentration of free stradiol in the blood serum of the pregnant woman decreases.

The median values ​​of free estradiol concentration in blood serum for screening of congenital malformations in the second trimester of pregnancy are shown in Table 15.

Table 15. Median concentrations of free estradiol in blood serum for screening of congenital malformations in the second trimester of pregnancy

In Down and Edwards syndrome, the concentration of free estradiol is usually 0.7 MoM.

In conclusion, we note that the widespread introduction of full-fledged ELISA diagnostics into clinical practice will significantly increase the efficiency of diagnosis and treatment of patients with disorders of the reproductive system.

Synonyms: 17-hydroxyprogesterone, 17-OHP, 17-OH progesterone, 17-OH-Pg, 17-hydroxyprogesterone, 17-hydroxyprogesterone, 17-OPG

To order

Discount price:

370 ₽

50% discount

Discount price:

370 + ₽ = 370 ₽

285 rub. RU-NIZ 425 rub. RU-SPE 250 rub. RU-KLU 250 rub. RU-TUL 250 rub. RU-TVE 250 rub. RU-RYA 250 rub. RU-VLA 250 rub. RU-YAR 250 rub. RU-KOS 250 rub. RU-IVA 250 rub. RU-PRI 250 rub. RU-KAZ 255 rub. 250 rub. RU-VOR 255 rub. RU-UFA 250 rub. RU-KUR 250 rub. RU-ORL 250 rub. RU-KUR 285 rub. RU-ROS 255 rub. RU-SAM 230 rub. RU-VOL 225 rub. RU-ASTR 245 rub. RU-KDA 360 rub. 360 rub. RU-PEN 265 rub. RU-ME 265 rub. RU-BEL

• Description
• Decoding
• Why Lab4U?

Due date

The analysis will be ready within 6 days, excluding Saturday and Sunday (except for the day of taking the biomaterial). You will receive the results by email. mail immediately when ready.

Completion time: 2 days, excluding Saturday and Sunday (except for the day of taking biomaterial) Preparation for analysis In advance

Do not take a blood test immediately after radiography, fluorography, ultrasound, or physical procedures.

To check the dynamics of the indicator, select the same analysis intervals each time.

Unless other dates are specified by the attending physician, blood sampling is recommended on days 21-23 of the menstrual cycle.

Discuss with your doctor the intake of medications the day before and on the day of the blood test, as well as other additional preparation conditions.

The day before

24 hours before blood collection:

Limit fatty and fried foods, do not drink alcohol.

Avoid sports training and emotional stress.

From 8 to 14 hours before donating blood, do not eat food, drink only clean, still water.

On the day of delivery

Do not smoke 60 minutes before blood collection.

Be in a calm state for 15-30 minutes before taking blood.

Analysis information

Indicator

17-hydroxyprogesterone is one of the hormones responsible for the formation of the reproductive system and the ability to bear children, along with estrogens and progesterone.

Appointments

The study is carried out to identify signs of hyperplasia (excessive cell proliferation) of the adrenal cortex. A specialist may also recommend a 17OH-Pg test for infertility, polycystic ovary syndrome, in combination with other research methods - if adrenal or ovarian cancer is suspected.

Specialist

Prescribed by a gynecologist, endocrinologist.

Research method - Enzyme-linked immunosorbent assay (ELISA)

Material for research - Blood serum

Composition and results of 17-OH progesterone

Find out more about pregnancy planning:

17-hydroxyprogesterone (17α-hydroxyprogesterone) is an intermediate product of the biosynthesis of glucocorticoids, estrogens and androgens. 17OH-Pg is a steroid produced by the adrenal cortex, ovaries, testes and placenta. It circulates in the blood both in a free and albumin-bound state. In the adrenal glands, 17-hydroxyprogesterone is converted to cortisol by the enzymes 21-hydroxylase and 11-b hydroxylase, in the ovaries it is converted to androstenedione, which is a precursor to estradiol and testosterone. The peak concentration of 17OH-Pg occurs in the luteal phase. During fertilization, the corpus luteum of the ovary continues to secrete 17-hydroxyprogesterone, however, if fertilization does not occur, the level of the hormone decreases. 17-OH-progesterone is characterized by ACTH-dependent diurnal fluctuations, the lowest values ​​are observed at night and the highest values ​​in the morning.

Determining the concentration of 17-hydroxyprogesterone (basal and ACTH-stimulated levels) as a result of a blood test is a necessary procedure to identify 21-hydroxylase deficiency, which most likely results in the development of congenital adrenal hyperplasia. Deficiency of the 21-hydroxylase enzyme causes a decrease in cortisol and aldosterone levels and an accumulation of 17-OH progesterone, which is sent to the androgen biosynthesis cycle. As a result of these processes, from the fetal period through infancy, large amounts of androgens cause severe progressive virilization. Due to the severity of this disease and the fairly high incidence, some countries have introduced a newborn blood screening program for 17OH-Pg. Monitoring of this metabolite is also used during steroid replacement therapy. In addition, analysis of 17-hydroxyprogesterone in response to parenteral administration of synthetic ACTH is performed to confirm the presumptive diagnosis of “partial” 21-hydroxylase deficiency as a possible cause of female hirsutism and infertility.

Interpretation of the results of the 17-OH progesterone study

Interpretation of test results is for informational purposes only, is not a diagnosis and does not replace medical advice. Reference values ​​may differ from those indicated depending on the equipment used, the actual values ​​will be indicated on the results form.

Unit: µg/l

Reference values:

	17-hydroxyprogesterone, mcg/l
3 months - 1 year
follicular phase
ovulation
luteal phase
postmenopause
Pregnant:
I trimester
II trimester
III trimester

Promotion:

• Congenital adrenal hyperplasia.
• Some adrenal tumors.
• Pregnancy.

Decrease:

• Addison's disease.
• Pseudohermaphroditism in men (17α-hydrolase deficiency).

Lab4U is an online medical laboratory whose goal is to make tests convenient and accessible so that you can take care of your health. To do this, we eliminated all costs for cashiers, administrators, rent, etc., directing the money to the use of modern equipment and reagents from the world's best manufacturers. The laboratory has implemented the TrakCare LAB system, which automates laboratory tests and minimizes the influence of the human factor

So, why without a doubt Lab4U?

• It is convenient for you to select assigned tests from the catalog or in the end-to-end search line; you always have at hand an accurate and understandable description of preparation for analysis and interpretation of results
• Lab4U instantly generates a list of suitable medical centers for you, all you have to do is choose the day and time, near your home, office, kindergarten or along the way
• You can order tests for any family member in a few clicks, entering them once into your personal account, quickly and conveniently receiving the results by email
• Analyzes are up to 50% more profitable than the average market price, so you can use the saved budget for additional regular studies or other important expenses
• Lab4U always works online with every client 7 days a week, this means that your every question and request is seen by managers, it is due to this that Lab4U is constantly improving its service
• An archive of previously obtained results is conveniently stored in your personal account, you can easily compare the dynamics
• For advanced users, we have created and are constantly improving a mobile application

We have been working since 2012 in 24 cities of Russia and have already completed more than 400,000 analyzes (data as of August 2017)

The Lab4U team is doing everything to make this unpleasant procedure simple, convenient, accessible and understandable. Make Lab4U your permanent laboratory