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    fertility basics

    Progesterone Test: Need, Indications, Test Results

    • 10725 views
    • 4.5   (1 Votes)
    Medically Reviewed by Dr. Deepika Tiwari - MS, MBBS on 15 Jun 2019 - Written by Dr. Aneesh Sabnis - Diploma, DFP, FCPS - Grammatically Approved by Dr. Kavita Jaggi Agrawal - MS, MBBS

    Progesterone test is a blood test that measures the level of progesterone hormone in the blood. It is done to find out the cause of infertility in women. It can help in checking on ovulation or obvious fertility problems. Progesterone pregnancy kit can be used to perform progesterone pregnancy test.

    A progesterone test helps in measuring the level of progesterone hormone with the help of a blood test. The levels of progesterone hormone vary during a woman’s menstrual cycle and different crucial phases of life. If conception has occurred, progesterone levels continue to rise as the body gets ready to support a developing baby in the womb of the woman. A test of progesterone levels in the first trimester could indicate whether the pregnancy is viable.

    Progesterone and Progestin:

    Progestin is a form of progesterone hormone, which plays a vital role in a woman’s menstrual cycle and pregnancy. Progestin is used in combination with another hormone known as estrogen, hormonal birth control pills, skin patch, and vaginal ring. It also can be used by itself in the form of progestin-only pills and the birth control injection. (1) Progesterone is an effective progestational steroid hormone secreted by the female reproductive system. It is linked to the menstrual cycle, pregnancy, and development of an embryo. Progestin is an artificial form of progesterone that is proved its usefulness in a range of cases. Progesterone is a steroid and a hormone as well. It has some prominent roles, particularly in the process of reproduction.(2)

    This article gives detailed information about:

    What is Progesterone Test?

    Serum progesterone is a blood test which has been considered as an effective test to discriminate a viable pregnancy from an ectopic pregnancy or abortion. Low progesterone values are linked with miscarriages and ectopic pregnancies. Both ectopic pregnancy and miscarriage are considered non-viable pregnancies, and high progesterone concentrations with viable pregnancies. Progesterone test can help fertility doctors check for possible fertility issues or ovulation. It can also determine whether everything is alright with an ongoing pregnancy and to ascertain the root cause of abnormal bleeding from the uterus. Serum progesterone is not always enough to diagnose a particular problem but it can help detect the problem when performed in combination with other tests. (3)Progesterone is a hormone in females that increases in concentration during a viable pregnancy. Studies have suggested that a single progesterone measurement in the first trimester can distinguish a viable pregnancy from a nonviable one, but results are contradictory.

    What is Progesterone Test

    The results or outcomes of the progesterone test were more impactful when it was performed in conjunction with a transvaginal ultrasound. Various research studies showed that in a major number of cases, women who had low progesterone levels had non-viable pregnancies. During the first trimester, about a third of pregnant women experience vaginal bleeding or abdominal pain. A viable pregnancy can be detected with the help of an ultrasound, but in a majority of over 30 percent cases, the results are uncertain. (4)Levels of progesterone vary during a woman's menstrual cycle. The levels start out low and then rise subsequently after the ovaries release an egg. When women become pregnant, progesterone levels continue to rise as their bodies get ready to support a developing baby.

    However, in cases where the egg is not fertilized (conception fails to occur), the progesterone levels will go down and the period will begin. In a pregnant woman, progesterone levels are about 10 times higher than they are in a woman who is not pregnant. Men also produce progesterone hormone, but in much smaller amounts when compared to women. (5)Progesterone levels are usually low during the follicular stage of a menstrual cycle. Ovulation is called the 'luteal stage' when the egg is released by the ovaries into the fallopian tube. After ovulation, progesterone levels rise for over 5 days before going back down. If pregnancy happens, the progesterone hormone levels begin to rise from the ninth week of pregnancy until the 32nd week of pregnancy. The placenta begins to produce progesterone after 12 weeks to help the pregnancy stay healthy. The levels of progesterone hormone vary to a certain extent as per the stage of a woman’s menstrual cycle and pregnancy. This is the reason why this test is repeated many times throughout the pregnancy. Certain types of cancer sometimes may lead to abnormal progesterone levels in men and women. (6)

    Indications for Progesterone Test:

    The most common indications for a progesterone test are:

    • To determine the reason for abnormal uterine bleeding
    • To determine the cause of female factor infertility
    • To determine if and when ovulation is taking place in a woman
    • Observe a high-risk pregnancy to determine fetal health and placenta
    • To determine the chances of miscarriage
    • To diagnose an ectopic pregnancy. An ectopic pregnancy takes place when the fertilized gets attached to a place other than inside the uterus. Most of the ectopic pregnancies occur in the fallopian tube and that’s why they are also called tubal pregnancies. (7)

    Why do women need a Progesterone Test?

    A progesterone blood test is considered to be the best sign of ovulation. Women need a progesterone test to help find and manage some minor to major causes of infertility and to improve the chances of achieving a healthy pregnancy. The main role of this steroid hormone is to help prepare the uterus so that it can successfully receive, implant, and support a fertilized egg in an ongoing pregnancy. A progesterone test is performed in conjunction with various other female hormones. A progesterone test works with proper examination and evaluating the level of progesterone hormone in the blood. Every month, the hormone estrogen causes the lining of the uterus, the endometrial lining, to develop and replenish itself which leads to the release of an egg from the ovaries. Luteinizing Hormone (LH) has a major role in the same event. The process is called ovulation. A corpus luteum then forms in the ovary at a place where the egg was released and starts producing progesterone.

    Why do women need a Progesterone Test

    This progesterone, which is supplemented by small amounts produced by the adrenal glands then curbs the endometrial growth and prepares the uterus for the possible implantation of a fertilized egg. When fertilization does not take place, the corpus luteum degenerates, levels of progesterone hormone drop and menstrual bleeding begins. When a fertilized egg gets implanted into the uterus, the corpus luteum produces progesterone hormone. The egg then forms a trophoblast which leads to the production of human Chorionic Gonadotropin (hCG) hormone. After a few weeks, the placenta replaces the corpus luteum as the main source of the hormone, thereby producing relatively large amounts of progesterone during a normal pregnancy. Progesterone hormone is produced at a much lower level in males which involves the growth and development of sperm. (8)

    Progesterone Test Preparations: What happens during the Progesterone Test?

    A progesterone test does not require any specific preparation. A progesterone test is a simple blood test which is done by collecting a blood sample from the patient. The only point a patient needs to make note of is the time of her last menstrual period. The patient must inform the doctor about the first and last day of her period. For women who experience light bleeding pattern or beginning with spotting, the first day is considered the day of comparatively high bleeding. For pregnant women, it is required to make note of the time period for how long the woman is pregnant. The fertility doctor or another health care expert will insert a needle in a vein in one of your arms or hand and take a bit of blood which is further sent in a lab for testing. (9) Certain medications may interfere with blood test results so consulting a doctor would be helpful. (10)

    What does Progesterone hormone do?

    • Progesterone plays a major role in preparing the tissue lining of the uterus in order to allow the fertilized egg to the implant with success
    • It helps in maintaining the endometrial lining of the uterus throughout pregnancy
    • Progesterone prevents further egg release until pregnancy has terminated
    • It also helps in preventing fertilization of more than one egg at a time, although more than one egg is occasionally released
    • Progesterone hormone helps in restricting the muscular contractions in the fallopian tubes once the egg has been transported
    • This crucial hormone plays a vital role in fetal development during pregnancy
    • The hormone also helps in stimulating the breast tissue to promote lactation and causes the glands to advance ready for the production of milk
    • Strengthens the pelvic wall muscles for the preparation of healthy labor at the end of the pregnancy

    When is Progesterone Test Recommended?

    The most common conditions under which progesterone levels may be measured are:

    • During an infertility evaluation, when a woman is struggling in getting pregnant and her highly-skilled healthcare provider wants to confirm that she is ovulating normally; the test may be recommended a few times during a woman's menstrual cycle to observe any change or fluctuations in progesterone levels in the body.
    • When it becomes necessary for the physician or healthcare provider to understand when ovulation has occurred and following medicine therapy for ovulation induction.
    • When symptoms like uterine spotting and abdominal pain occur, suggesting a possible risk of ectopic pregnancy or threatened miscarriage, a progesterone test is recommended in such cases.
    • This test is also suggested where a woman's case requires progesterone replacement therapy to help retain her pregnancy.
    • Periodically throughout in the cases of a high risk pregnancy, a progesterone test to observe placenta and fetal health
    • When a non-pregnant woman witnesses abnormal uterine bleeding

    Progesterone Test Results:

    Interpretation of progesterone hormone test results relies on the reason for testing. It also requires the demand of the situation at which a woman is in her menstrual cycle or pregnancy. Progesterone levels usually start to rise when an egg is released from the ovary, rise for several days, and then either continue to rise in the first trimester or fall to initiate menstruation in the concerned woman. When the progesterone levels do not increase and decrease on a monthly basis, a woman may not be ovulating or having regular menstrual periods. This can also lead to infertility in the respective woman. If levels do not rise normally during the first trimester, the pregnancy can be considered to be ectopic and/or may be failing. If serial measurements do not depict rising progesterone levels over time, there may be issues with the viability of the placenta and fetus. Low levels of progesterone may be associated with:

    Progesterone Test Results

    • Pre-eclampsia
    • Fetal death/miscarriage
    • Lack of menstruation (amenorrhea)
    • Ectopic pregnancy
    • Decreased function of ovaries
    • Toxemia - a condition commonly called as preeclampsia is a condition that may happen late in pregnancy but could be serious if left untreated

    High levels of progesterone may be associated with:

    • A rare form of ovarian cancer
    • Adrenal cancer
    • Ovarian cysts
    • Glands producing too much progesterone

    Progesterone Test Results Range:

    Progesterone levels are measured in nanograms per milliliter (ng/mL). Below are ranges that are considered normal in progesterone test results:

    • 0.1-0.3 ng/mL for prepubescent girls
    • 0.1-0.7 ng/mL for women who are in the follicular stage of their menstrual cycle
    • 2-25 ng/mL for women who are in the luteal stage of the menstrual cycle
    • 10-44 ng/mL during early pregnancy
    • 19.5-82.5 ng/mL during the second trimester
    • 65-290 ng/mL during the third trimester

    Other conditions that may depict abnormal progesterone test results:

    • Increased progesterone during pregnancy indicates that the woman is carrying twins or an abnormal type of pregnancy known as a molar pregnancy.
    • Increased progesterone when a woman is not pregnant could mean that she has a certain type of ovarian tumor known as a lipid ovarian tumor or chorionepithelioma.
    • Decreased progesterone levels during pregnancy could mean that a woman is at risk of spontaneous abortion (miscarriage)
    • Decreased progesterone when a woman isn't pregnant could mean that she doesn't have enough female hormones. This condition is known as hypogonadism.

    Factors affecting Progesterone Test Results:

    The factors which might affect the result of the progesterone test include certain medications like birth control drugs or steroids.

    Frequently asked questions related to progesterone test:

    Frequently Asked Questions Related to Progesterone Test

    Q. Do patients need to fast for a progesterone blood test?

    Progesterone test usually does not require fasting. The results of progesterone test can be availed by the patient in one or two days. Insurance and a fertility doctor's order are not mandatory while ordering this test. It is a female hormone produced by the ovaries during ovulation.

    Q. What are the levels of progesterone hormone that indicate ovulation?

    Ovulation usually takes place in the mid of the menstrual cycle. A progesterone level above 3 usually indicates that ovulation has occurred and a level 10 or higher generally determines adequate production of the progesterone level to maintain a healthy pregnancy.

    Q. What other tests does serum progesterone involve?

    The progesterone blood test is performed in conjunction with other tests in order to obtain accurate results. Other blood tests may be performed to check on the ability of the patient to get pregnant. An ultrasound may be recommended to measure the thickness of the lining of your uterus or the endometrial lining. A specific blood test may be recommended, if a patient is already pregnant, to figure out if there are any issues with an ongoing pregnancy. For patients with pain or bleeding who did not undergo an ultrasound, the progesterone test was significantly less accurate in predicting the viability of a healthy pregnancy.(11)

    Q. What are the risks associated with a serum progesterone test?

    Certain risks surround the person who is undergoing the serum progesterone test. For most people, these risks are ignorant and minor. During the blood test, the patient might feel some stingy pain when the needle is inserted into the vein for taking out the required amount of blood. He/she might bleed for a few minutes after the needle is removed, which settles down in some time. A bruise might also develop in the area surrounding the test site. Afterward, the site may be sore. More serious complications are rare in the progesterone test. Other rare complications or risk associated with progesterone testing can be inflammation of your vein, fainting, and infection at the puncture site. If patients already have a bleeding disorder, the risks of a blood draw tend to be at a higher level.

    Q. How do you know your progesterone is low?

    If you aren't pregnant, some symptoms of low progesterone may include:

    • Low libido
    • Hot flashes
    • Migraine or headache
    • Depression, anxiety or mood swings
    • Absent or irregular menstrual cycle

    Q. What does a 21-day progesterone test tell depict?

    Day 21 fertility testing depicts a woman's progesterone level to determine whether ovulation has occurred. It is performed on day 21 of the menstrual cycle (Day 1 is the first day of flow, not including any spotting). A low progesterone level on Day 21 suggests the cycle was anovulatory (no egg was produced). Serial estradiol (E2) levels are usually measured for observing superovulation in ART methods such as Intrauterine Insemination (IUI) and In Vitro Fertilization (IVF) treatment cycles.

    Q. Foods which help in low progesterone:

    Some foods which are considered helpful in low progesterone include:

    1. Zinc

    Zinc is considered to be a vital nutrient for progesterone hormone. It has an effective role to play infertility and body development during pregnancy. Foods which are rich in zinc are:

    • Kidney beans
    • Cashew nuts and almonds
    • Chickpeas
    • Shellfish

    These foods can help in reducing the symptoms causing low progesterone levels in pregnant women.

    2. Vitamin B-6

    Vitamin B-6 has an important role to play in managing liver function, which helps to keep the crucial hormone levels balanced. Foods that contain high levels of vitamin B-6 include:

    • Bananas
    • Chickpeas
    • Potatoes
    • Tuna
    • Spinach
    • Lean Red Meat

    Q. How to test progesterone levels at home?

    Progesterone check is a finger-prick blood test kit. With the help of this finger prick kit, the test for progesterone levels can be performed at home in a hassle-free manner. It is then sent to the accredited laboratory for analysis. It’s a useful blood test for women who are planning to start a family. The test is also helpful for women who want to check whether they have ovulated. A progesterone test kit is the most reliable and proven medical method to establish whether a woman has ovulated, in a quick and affordable manner. In order to achieve highly accurate results from this test, it’s important that a woman takes it on day 21 of her menstrual period (or 7 days before the start of your next period). The best time to perform a progesterone test is 4 to 5 days after the Luteinizing Hormone (LH) is detected as the progesterone hormone is released after ovulation.

    Results of the progesterone test:

    2 lines depict Negative progesterone test

    1 line depict Positive progesterone test

    Thus, medical tests are useful in different stages of a woman's life. The use of these medical tests needs to be performed. Elawoman is here to help you in solving all the queries related right from planning to start your pregnancy journey until the successful baby delivery. Just like the progesterone test results, Elawoman can set you on the right path towards a healthy pregnancy and good health. Feel free to visit elawoman.com or call us at +918929020600to get complete guidance and effective counseling for all infertility and IVF related issues.

    Dr. Aneesh Sabnis

    Written by

    Diploma, DFP, FCPS, DNB, MBBS, MD, DGO
    Laparoscopic Surgeon, Gynecologic Surgeon
    Mumbai
    Dr. Aneesh Sabnis is an IUI Specialist and Obstetrician with a considerable experience of over two decades. His areas of expertise are Normal Vaginal Delivery (NVD), Myomectomy, Infertility Treatment, Hysterectomy (Abdominal/Vaginal) and Laparoscopic Surgery. Currently, he is associated with Sneh Nursing Home in Andheri, Mumbai. Dr. Aneesh Sabnis has done MD in Obstetrics and Gynaecology, DNB in Obstetrics and Gynecology, and FCPS in Mid. and Gynae from L.T.M.M.College and L.T.M.G Hospital, Sion in 1995. He is also a member of various medical associations such as Federation of Obstetrics and Gynaecological Societies of India (FOGSI), Indian Association Of Gynaecological Endoscopist (IAGE), and Indian Medical Association (IMA). For detailed description about the doctor and contact details visit elawoman.com

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