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UK NEQAS for Steroid Hormones will be able to access the following: https://results.ukneqas.org.uk/output/QEHSTER/Prog_Rainbow_A1_Instr_2015.pdf Regards Aimee Aimee McGrory EQA Support Scientist - NEQAS From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of McKillop, Derek Sent: 10 March 2017 10:10 To: [log in to unmask] Subject: Re: Day 21 progesterone cut-offs Angela We quote the values stated in the NICE guidelines, see extract below Derek [cid:image003.png@01D235D3.A0721B90] Dr Derek McKillop PhD FRCPath Consultant Clinical Scientist Lead Consultant for Clinical Biochemistry * Southern Health and Social Care Trust Craigavon Area Hospital BT63 5QQ ( 02838360686 60842 4 028 38334582 : Laboratory website<http://vsrintranet/SHSCT/Labs/webhb/default.htm> [Description: Description: T:\qrcode SHSC labs.png] From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Burns Angela - Clinical Scientist Sent: 10 March 2017 09:37 To: [log in to unmask]<mailto:[log in to unmask]> Subject: Re: Day 21 progesterone cut-offs Just to clarify, we do use the Siemens Centaur method for Progesterone in Leicester Kind regards Dr Angela Burns née Kinnell Senior Clinical Scientist The Department of Chemical Pathology and Metabolic Medicine Level 4, Sandringham Building Leicester Royal Infirmary LE1 5WW 0116 258 7589 From: Mohammad Al-Jubouri [mailto:[log in to unmask]] Sent: 08 March 2017 14:33 To: Burns Angela - Clinical Scientist; [log in to unmask]<mailto:[log in to unmask]> Subject: RE: Day 21 progesterone cut-offs Hi Angela, This is my personal view: In a normal menstrual cycle (28Day), progesterone is produced by the corpus luteum after ovulation has occurred at mid-cycle (D14) and continue to rise to a peak at D21. Therefore I would argue that ovulation occurs even if D21 progestrone is as low as 10 nmol/L, however this would suggest unhealthy corpus luteum that is unable to sustain healthy decidual endometrial growth in order for the fertilised ovum to implant. In a regular 28D cycle, ovulation should occur in every cycle and D21 progesterone is only an index of corpus luteal health and not an index of ovulation. The higher D21 progesterone the more likely that healthy decidual reaction occurs ready for implantation of fertilised ovum. So D21 progesterone of 10 - 20 nmol/L means that ovulation has happened but corpus luteal function is inadequate to support decidual reaction so implantation of a fertilised ovum is less likely to happen. Day21 progesterone of 21 - 28 nmol/L also means that ovulation has happened but luteal function is sub-optimal but could support decidual reaction and therefore offer some chance for implantation. Day 21 progesterone of >29 nmol/L, luteal function is healthy and there is a higher chance of successful implantation of a fertilised ovum. Day 21 <10 nmol/L, there will be minimal if any decidual reaction, so no chance of implantation even if ovulation has occurred.. Therefore we should not be linking D21 progesterone to ovulation but instead we should link it to corpus luteal function. Regards Mohammad Dr. M. A. Al-Jubouri MBChB, FRCP Edin, FRCPath Consultant Chemical Pathologist Clinical Director of Pathology St. Helens & Knowsley Teaching Hospitals [Description: Description: Description: Description: HSJ logo (2)] From: Clinical biochemistry discussion list [mailto:[log in to unmask]]<mailto:[mailto:[log in to unmask]]> On Behalf Of Burns Angela - Clinical Scientist Sent: 08 March 2017 13:30 To: [log in to unmask]<mailto:[log in to unmask]> Subject: Day 21 progesterone cut-offs Dear Mailbase We have been contacted by our Gynaecologists suggesting that we lower our current cut-offs for day 21 progesterone. We currently report the following cut-offs: >30 nmol/L it's probably Ovulatory 20-30 nmol/L it's Equivocal <20 nmol/L it's probably Non Ovulatory Based on audit work the Gynaecologists have suggested the following cut-offs: >20 nmol/L probably ovulatory 10-20 nmol/L equivocal < than 10: probably non-ovulatory What do other labs use? Kind regards Dr Angela Burns née Kinnell Senior Clinical Scientist The Department of Chemical Pathology and Metabolic Medicine Level 4, Sandringham Building Leicester Royal Infirmary LE1 5WW ________________________________ This e-mail, including any attached files, may contain confidential and / or privileged information and is intended for the exclusive use of the addressee(s) printed above. If you are not the addressee(s), any unauthorised review, disclosure, reproduction, other dissemination or use of this e-mail, or taking of any action in reliance upon the information contained herein, is strictly prohibited. If this e-mail has been sent to you in error, please return to the sender. No guarantee can be given that the contents of this email are virus free - The University Hospitals of Leicester NHS Trust cannot be held responsible for any failure by the recipient(s) to test for viruses before opening any attachments. 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