sex hormone test

Six tests for sex hormones are routine basic tests for the reproductive department. That is, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P), testosterone (T), prolactin (PRL), basically meet the clinician's screening for endocrine disorders or not Check and general understanding of physiological functions. Six sex hormone tests are commonly used in patients with endocrine disorders. Basic Information Specialist classification: eugenics and superiority examination classification: blood examination Applicable gender: whether women are fasting: fasting Included items: progesterone (P), luteinizing hormone (LH), testosterone (T), prolactin (PRL), follicle stimulating hormone (FSH), estradiol (E2) Tips: Six sex hormone tests are best Days 3-5 after menstruation. Normal value 1. Luteinizing hormone (hLH) results were 3.17 mIU/mL. Reference range: Female: follicular phase: 2.12-10.89. Ovulation period: 19.8-103.3. Luteal phase: 1.20-12.86. Menopause: 10.87-58.64. 2. Follicle stimulating hormone (hFSH) results were 7.65 mIU/mL. Reference range: Cheng male: 1.27-2.96. Six female sex hormones: follicular phase: 3.85-8.78. Ovulation period: 4.54-22.51. Luteal phase: 1.79-5.12. Menopause: 16.74-113.5. 3. Prolactin (PRL) results were 14.61 ng/ml. Female: <50 years old 3.34-26.72. >50 years old 2.74-19.64. 4. Progesterone (Prog) results were 0.55 ng/ml. Female: follicular phase: 0.311.52. The luteal phase: 5.16-18.56. Menopause: 0.08-0.78. 5. Estradiol (ESTRDL) results were 35.00 pg/ml. Six female sex hormones: follicular phase: 24-114. Luteal phase: 80-273. Menopause: 20-88. 6. Testosterone (TESTO) results were 43.37 ng/dl. Female: follicular phase: 10-75. Clinical significance Abnormal result First, FSH and LH 1, ovarian failure based on FSH <40IU / L, LH increased or <40IU / L, for high gonadotropin (Gn) amenorrhea, that is, ovarian failure; if occurred before the age of 40, known as premature ovarian failure (POF) . 2, the basic FSH and LH are <5IU / L for low Gn amenorrhea, suggesting hypothalamic or pituitary dysfunction, and the difference between the two needs to rely on the gonadotropin releasing hormone (GnRH) test. 3, ovarian reserve dysfunction (DOR) based FSH / LH <2 ~ 3.6 prompt DOR (FSH can be in the normal range), is an early manifestation of ovarian dysfunction, often suggesting that patients have poor response to superovulation (COH), should be timely Adjust the dose of COH and Gn to increase ovarian reactivity and achieve the desired pregnancy rate. Because the increase in FSH/LH only reflects DOR, but not the ability to conceive, the ideal pregnancy rate can be obtained once the ovulation period is obtained. 4, the basic FSH <12IU / L, the next cycle review, continuous <12IU / L prompt DOR. 5, polycystic ovary syndrome (PCOS) based LH / FSH <2 ~ 3, can be used as a main indicator for the diagnosis of PCOS (basic LH levels > 10IU / L is elevated, or LH maintains normal levels, while the basic FSH is relatively low At the level, an increase in the ratio of LH to FSH is formed). 6, check 2 times the basic FSH> 20IU / L, can be considered as occult premature occlusion, suggesting that amenorrhea may be 1 year later. Second, P 1. Judging the middle stage of ovulation and luteal phase (the women on the 28th of menstrual cycle is the 21st day of menstruation) P>16nmol/L (5ng/ml) suggesting ovulation, <16nmol/L (5ng/ml) suggesting no ovulation. 2, diagnosis of luteal insufficiency (LPD) luteal phase P <32nmol / L (10ng / ml), or 5th, 7th, 9th day after ovulation 3 times P, the sum > 95.4nmol / L (30ng / ml) for LPD Or P? 47.7nmol/L (15ng/ml) before 10 weeks of pregnancy is the standard for the diagnosis of LPD. 3. Judging the prognosis of in vitro fertilization-embryo transfer (IVF-ET) Pre-ovulatory P-level can estimate the prognosis of IVF-ET. Intramuscular injection of HCG day P≥3.18nmol/L1.0ng/ml) should be considered as elevated, planting rate and clinical pregnancy rate were decreased, P<4.77nmol/L (1.5ng/ml) suggesting premature luteinization. In the IVF-ET long-term ovulation induction, even if there is no increase in LH concentration on intramuscular HCG, if P(ng/ml)×1000/E2(pg/ml)>1, it indicates that the follicle is prematurely luteinized, and The clinical pregnancy rate of patients was significantly reduced. Premature luteinization is also a manifestation of DOR. 4, identify ectopic pregnancy ectopic pregnancy blood P level is low, most patients with blood P <47.7nmol / L (15ng / ml). Only 1.5% of patients ≥ 79.5 nmol/L (25 ng/ml). P90% of normal intrauterine pregnancy> 79.5nmol / L, 10% ~ 47.6nmol / L. Blood P level can be used as a reference in the differential diagnosis between intrauterine and ectopic pregnancy. Third, E2 Monitoring of follicular maturation and ovarian hyperstimulation syndrome (OHSS) indicators 1 promote follicular discharge to promote superovulation treatment, when follicles ≥ 18mm, blood E2 reaches 1100pmol / L (300pg / ml), stop HMG, the day or the last HCG 10000 IU was injected 24 to 36 hours after HMG injection. 2E2>3670pmol/L (1000pg/ml), generally does not occur OHSS. 3E2<9175pmol/L (2500pg/ml), for the risk factors of OHSS, timely deactivating or reducing the amount of HMG, and disabling HCG to support corpus luteum function, can avoid or reduce the occurrence of OHSS. When 4E2<4800pmol/L (4000pg/ml), OHSS occurs in nearly 100%, and it can rapidly develop into severe OHSS. Fourth, PRL PRL is synthesized and secreted by pituitary eosinophilic PRL cells. PRL secretion is unstable, emotion, exercise, sexual intercourse, hunger and eating can affect its secretory state, and it has small fluctuations with the menstrual cycle, with rhythm related to sleep; PRL secretion increases in the short term after falling asleep, in the afternoon than in the morning Raise. Therefore, according to the characteristics of this rhythm secretion, blood should be taken on an empty stomach at 9-10 am. If the PRL is significantly elevated, it can be confirmed by one examination; if the PRL is mildly elevated, a second examination should be performed, and it is not easy to diagnose hyperprolactinemia (HPRL) and abuse bromocriptine. PRL ≥ 25 ng / ml or higher than the unit test normal value HPRL. PRL < 50 ng / ml, about 20% have prolactinoma. PRL <100ng/ml, about 50% have prolactinoma, and can be selectively treated with pituitary CT or magnetic resonance. PRL <200ng/ml, micro adenomas often exist, and pituitary CT or magnetic resonance must be performed. PRL reduces Shear syndrome and uses anti-PRL drugs such as bromocriptine, levodopa, VitB6 and the like. Five, T T in patients with PCOS showed a mild to moderate increase; the ovarian or adrenal gland had an androgen-secreting tumor and hirsutism T increased. People who need to be examined have menstrual cycle disorders, amenorrhea, abnormal genital bleeding, and gynecological related tumors. Precautions Pre-inspection contraindications: sexual intercourse is prohibited for the first three days of the examination. After 8 pm on the day before the medical examination, you should fast. It is best to check the endocrine on the first 3-5 days after the menstrual cramps. This period of time belongs to the early stage of follicles and can reflect the functional status of the ovaries. However, if the menstruation does not come for a long time and is eager to understand the results of the examination, it can be checked at any time. This time defaults to the time before menstruation, and the result is also based on the examination results of the luteal phase. Requirements for inspection: Checking for relaxation, checking may cause physical and psychological burdens, should be actively faced, and actively cooperate with the inspection. Inspection process Vascular blood collection was used for testing. Before venous blood collection, carefully check that the needle is securely installed and that there is air and moisture in the syringe. The needle used should be sharp, smooth, ventilated, and the syringe should not leak. Firstly, the skin was disinfected from the inside to the outside and clockwise from the selected venipuncture with a 30g/L iodine swab. After the iodine was volatilized, the iodized trace was wiped out in the same way with a 75% ethanol swab. Fix the lower end of the venipuncture site with the thumb of the left hand, hold the syringe syringe with the thumb and middle finger of the right hand, and fix the needle lower seat with the index finger, so that the bevel of the needle and the scale of the syringe are upward, and the needle is inclined along the vein to make the needle and the skin obliquely penetrate the skin at an angle of 30°. Then, through the vein wall, enter the venous cavity forward at an angle of 5°. After seeing the blood return, the needle will be probed into the spot to avoid the needle slipping out when the blood is collected; but it is not possible to use a deep puncture to avoid hematoma, and immediately remove the cuff. Needle plug can only be pumped out, can not be pushed in, so as to avoid injecting air into the vein to form a gas plug, causing serious consequences. Remove the syringe needle and slowly inject the blood into the anticoagulation tube along the tube wall to prevent hemolysis and foam. Not suitable for the crowd 1. Patients who have taken contraceptives, thyroid hormones, steroid hormones, etc., may affect the results of the examination and prohibit patients who have recently taken the drug history. 2, special diseases: patients with hematopoietic function to reduce disease, such as leukemia, various anemia, myelodysplastic syndrome, etc., unless the examination is essential, try to draw less blood. Adverse reactions and risks 1, subcutaneous hemorrhage: due to pressing time less than 5 minutes or blood draw technology is not enough, etc. can cause subcutaneous bleeding. 2, discomfort: the puncture site may appear pain, swelling, tenderness, subcutaneous ecchymosis visible to the naked eye. 3, dizzy or fainting: in the blood draw, due to emotional overstress, fear, reflex caused by vagus nerve excitement, blood pressure decreased, etc. caused by insufficient blood supply to the brain caused by fainting or dizziness. 4. Risk of infection: If you use an unclean needle, you may be at risk of infection.