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Done tests on mid cycle. Kindly let me know whether the results are normal or out of range

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I got the following tests done on MID CYCLE day 4:
E2 - 605.64 pg/ml
FSH - 8.18 mIU/ml
LH - 6.14 mIU/ml
Prolectin - 19.30 ng/ml
The below test was done before random:
AMH - 0.45 ng/ml
Kindly let me know about the above results are normal or out of range.

Posted Sun, 29 Apr 2012 in Women's Health
 
 
Answered by Dr. Rakhi Tayal 55 minutes later
Hello,

Thanks for posting your query.

As you have requested, I am mentioning below the normal ranges of the tests you have undergone.

Follicle Stimulating Hormone (FSH) Day 4, 3-20 m IU/ml

Luteinizing Hormone (LH) Day 4 < 7 m IU/ml

Prolactin Day 4 < 24 ng/ml

Estradiol (E2) Day 4 upto 80 pg/ml

Normal AMH levels range between 0.7ng/ml to 3.5ng/ml.

Now interpreting your results, Your FSH, LH and prolactin levels are within normal range.

Serum estradiol E2 levels are raised and AMH levels are on a lower side.

AMH levels between 0.3- 0.7 ng/ml are borderline low and indicate a slightly lower number of formations of eggs in the ovary. It indicates a borderline decreased fertility.

High levels of estradiol early in the cycle are indicative of a lower pregnancy rate during assisted reproductive techniques like IVF (InVitroFertilization). Such high levels are usually suggestive of a poor quality egg formation. It can interfere with normal growth of the uterine lining and it can also inhibit follicle selection and growth during the next cycle.

I encourage you to consult an infertility specialist for further treatment.

Please accept my answer in case you do not have further queries.

Wishing you good health.

Regards.
Dr. Rakhi Tayal.
Above answer was peer-reviewed by
 
Follow-up: Done tests on mid cycle. Kindly let me know whether the results are normal or out of range 1 hour later
Name: XXXXXXX Collected:21/02/12 13:46
Lab. No:12 0000 Age:44 years Gender : F Received :21/02/12 13:46
A/C Status:C Ref. By:DR. (MRS. ) XXXXXXX GARG Printed :21/02/12 18:06
Test Name Result Units Ref. Range
-------------------------------------------------------------------------
| ESTRADIOL; E2 605.64 pg/mL |
| (CLIA) |
--------------------------------------------------------------------------
Interpretation
-----------------------------------------------------------------
|Reference |Reference range |Reference range |
|Group |in pg/mL (Males) |in pg/mL (Females) |
|------------------|------------------|---------------------------|
| 1 - 5 years | 3 - 10 | 5 - 10 |
|------------------|------------------|---------------------------|
| 6 - 9 | 3 - 10 | 5 - 60 |
|------------------|------------------|---------------------------|
| 10 - 11 years | 5 - 10 | 5 - 300 |
|------------------|------------------|---------------------------|
| 12 - 14 years | 5 - 30 | 24 - 410 |
|------------------|------------------|---------------------------|
| 15 - 17 years | 5 - 45 | 40 - 410 |
|------------------|------------------|---------------------------|
| Adults | 10 - 50 |Menstrual phase |
| | | |
| | | Early Follicular phase: |
| | | 20 - 150 |
| | | Late Follicular phase: |
| | | 40 - 350 |
| | | Mid cycle : |
| | | 150 - 750 |
| | | Luteal phase: |
| | | 30 - 450 |
| | |Post Menopausal:< 21 |
-----------------------------------------------------------------
Clinical Use
* Determine estrogen status in women
* Monitor follicular development during induction of ovulation
* Assess estrogen production in males
Increased Levels
* Precocious puberty (female)
* Male gynecomastia
Page 1

Name: XXXXXXX Collected:21/02/12 13:46
Lab. No:12 0000 Age:44 years Gender : F Received :21/02/12 13:46
A/C Status:C Ref. By:DR. (MRS. ) XXXXXXX GARG Printed :21/02/12 18:06
Test Name Result Units Ref. Range
* Liver disease
* Ovarian tumors
* Adrenal feminizing tumors
Decreased Levels
* Oral contraceptives
* Ovarian failure
HEALTHY WOMEN PACKAGE
Calcium, Serum 8.30 mg/dL (8.80 - 10.60)
(Arsenazo III)
Comments:
Calcium is an important mineral found mainly in bones(99%) & teeth. In
bone, it combines with phosphorus to form hydroxyapatite crystals,
giving strength to the bone structure and providing constant reservoir
of calcium. It is also important in blood coagulation, muscle contraction,
hormone action, glycogen metabolism, cell division and membrane
permeability. Calcium exists in three physiochemical states in plasma,
of which approximately 50% is free or ionized, 40% is bound to plasma
proteins mainly albumin & 10% is complexed with small anions including
bicarbonate, lactate, phosphate and citrate.
Decreased levels of calcium are found in hypoparathyroidism, pseudohypoparathyroidism,
malabsorption of calcium & vit D, obstructive
jaundice, chronic renal disease with uremia and phosphate retention,
acute pancreatitis with extensive fat necrosis, starvation, late
pregnancy, hypomagnesemia, use of certain drugs viz. antibiotics,
chemotherapeutic agents, calcitonin, etc.
Page 2

Name: XXXXXXX Collected:21/02/12 13:46
Lab. No:12 0000 Age:44 years Gender : F Received :21/02/12 13:46
A/C Status:C Ref. By:DR. (MRS. ) XXXXXXX GARG Printed :21/02/12 18:06
Test Name Result Units Ref. Range
Phosphorus, Serum 2.90 mg/dL (2.40 - 4.40)
(Molybedate UV)
Comments:
Inorganic phosphate is an important component of hydroxyapatite in
bone providing structural support and intra and extra cellular pools
of phosphate in body.
Most of cellular component is organic and is incorporated into nucleic
acids, phospholipids, phosphoproteins & high energy compounds involved
in cellular integrity and metabolism. Plasma contains approx. 2.5-4.5
mg/dL of inorganic phosphate.
Increased phosphate levels are associated with decreased glomerular
filteration rate as encountered in renal failure (chronic or acute),
hypoparathyroidism, hyperthyroidism, neoplasm, sickle cell anaemia,
sarcoidosis and high intestinal obstruction etc.
Decreased phosphate levels are associated with lowering of renal thres
holds. Fanconi's syndrome, hypokalemia,diuretics, gout, malabsorption,
diabetes mellitus, alcoholism etc.
Page 3

Name: XXXXXXX Collected:21/02/12 13:46
Lab. No:12 0000 Age:44 years Gender : F Received :21/02/12 13:46
A/C Status:C Ref. By:DR. (MRS. ) XXXXXXX GARG Printed :21/02/12 18:06
Test Name Result Units Ref. Range
----------------------------------------------------------------------
| IRON STUDIES, SERUM |
| (TPTZ, Calculated) |
| |
|Iron 82.00 ug/dL (50.00 - 170.00) |
| |
|Total Iron Binding Capacity 308.00 ug/dL (250.00 - 425.00)|
| |
|Transferrin Saturation 27 % (15 - 50) |
| |
----------------------------------------------------------------------
Iron is an essential trace mineral element which forms an important
component of hemoglobin, metallocompounds and Vitamin A. Deficiency
of iron, leads to microcytic hypochromic anemia.The toxic effects of
iron are deposition of iron in various organs of the body and hemochromatosis.
Total Iron Binding capacity (TIBC) is a direct measure of the
protein Transferrin which transports iron from the gut to storage
sites in the bone marrow. In iron deficiency anemia, serum iron is
reduced and TIBC increases.
Transferrin Saturation occurs in idiopathic hemochromatosis and
transfusional hemosiderosis where no unsaturated iron binding capacity
is available for iron mobilization. Similar condition is seen in
congenital deficiency of Transferrin.
Page 4

Name: XXXXXXX Collected:21/02/12 13:46
Lab. No:12 0000 Age:44 years Gender : F Received :21/02/12 13:46
A/C Status:C Ref. By:DR. (MRS. ) XXXXXXX GARG Printed :21/02/12 18:06
Test Name Result Units Ref. Range
-------------------------------------------------------------------------
| FSH;FOLLICLE STIMULATING HORMONE 8.18 mIU/mL |
| (CLIA) |
-------------------------------------------------------------------------
-----------------------------------------------------------------
| Adult Females | Reference Range in mIU/mL |
|-----------------------------------|-----------------------------|
|Follicular | 2.50 - 10.20 |
|Mid Cycle Peak | 3.40 - 33.40 |
|Luteal Phase | 1.50 - 9.10 |
|Post Menopausal | 23.00 - 116.30 |
|Pregnant | <0.30 |
-----------------------------------------------------------------
Clinical Use
* Diagnosis of gonadal function disorders
* Management and treatment of infertility in both genders
Increased levels
* Primary hypogonadism
* Gonadotropin secreting pituitary tumors
* Menopause
Decreased levels
* Hypothalamic GnRH deficiency
* Pituitary FSH deficiency
* Ectopic steroid hormone production
Page 5

Name: XXXXXXX Collected:21/02/12 13:46
Lab. No:12 0000 Age:44 years Gender : F Received :21/02/12 13:46
A/C Status:C Ref. By:DR. (MRS. ) XXXXXXX GARG Printed :21/02/12 18:06
Test Name Result Units Ref. Range
-------------------------------------------------------------------------
| LH; LUTEINISING HORMONE 6.14 mIU/mL |
| (CLIA) |
-------------------------------------------------------------------------
-----------------------------------------------------------------
| Adult Females | Reference Range in mIU/mL |
|-----------------------------------|-----------------------------|
|Follicular | 1.90 - 12.50 |
|Mid Cycle Peak | 8.70 - 76.30 |
|Luteal Phase | 0.50 - 16.90 |
|Post Menopausal | 15.90 - 54.00 |
|Pregnant | 0.10 - 1.50 |
|Oral Contraceptives | 0.70 - 5.60 |
-----------------------------------------------------------------
Clinical Use
* Diagnosis of gonadal function disorders
* Diagnosis of pituitary disorders
Increased levels
* Primary hypogonadism
* Gonadotropin secreting pituitary tumors
* Menopause
* Luteal phase of menstrual cycle
* Polycystic ovarian disease
Decreased levels
* Hypothalamic GnRH deficiency
* Pituitary LH deficiency
* Ectopic steroid hormone production
* GnRH analog treatment
Page 6

Name: XXXXXXX Collected:21/02/12 13:46
Lab. No:12 0000 Age:44 years Gender : F Received :21/02/12 13:46
A/C Status:C Ref. By:DR. (MRS. ) XXXXXXX GARG Printed :21/02/12 18:06
Test Name Result Units Ref. Range
-------------------------------------------------------------------------
| PROLACTIN, SERUM 19.30 ng/mL |
| (CLIA) |
-------------------------------------------------------------------------
Interpretation:
--------------------------------------------------------------
| Reference Group | Reference Range in ng/mL |
|-----------------------------|--------------------------------|
| Females | |
| Non Pregnant | 2.80 - 29.20 |
| Pregnant | 9.70 - 208.50 |
| Post Menopausal | 1.80 - 20.30 |
|-----------------------------|--------------------------------|
| Males | 2.10 - 17.70 |
--------------------------------------------------------------
-----------------------------------------------------------------
| Children | Reference Range in | Reference Range in |
| | ng/mL (Males) | ng/mL (Females) |
|--------------|-------------------------|------------------------|
|Tanner Stage 1| < 10 (<9.8 yrs) |3.60-12.0 (<9.2 yrs) |
|--------------|-------------------------|------------------------|
|Tanner Stage 2| < 6.1 (9.8-14.5 yrs) |2.60-18.0 (9.2-13.7yrs) |
|--------------|-------------------------|------------------------|
|Tanner Stage 3| < 6.1 (10.7-15.4 yrs) |2.60-18.0 (10-14.4 yrs) |
|--------------|-------------------------|------------------------|
|Tanner Stage 4|2.80-11.0 (11.8-16.2 yrs)|3.20-20.0(10.7-15.6 yrs)|
|--------------|-------------------------|------------------------|
|Tanner Stage 5|2.80-11.0 (12.8-17.3 yrs)|3.20-20.0(11.8-18.6 yrs)|
-----------------------------------------------------------------
Note: 1. Since prolactin is secreted in a pulsatile manner and is
also influenced by a variety of physiologic stimuli, it
is recommended to test 3 specimens at 20-30 minute intervals
after pooling.
2. Major circulating form of Prolactin is a nonglycosylated
monomer, but several forms of Prolactin linked with immunoglobulin
occur which can give falsely high Prolactin results.
3. Macroprolactin assay is recommended where prolactin levels
are elevated with no signs and symptoms of hyperprolactinemia
and normal pituitary imaging studies.
Page 7

Name: XXXXXXX Collected:21/02/12 13:46
Lab. No:12 0000 Age:44 years Gender : F Received :21/02/12 13:46
A/C Status:C Ref. By:DR. (MRS. ) XXXXXXX GARG Printed :21/02/12 18:06
Test Name Result Units Ref. Range
Clinical Use
* Diagnosis & management of pituitary adenomas
* Differential diagnosis of male & female hypogonadism
Increased Levels
* Physiologic: Sleep, stress, postprandially, pain, coitus,
pregnancy, nipple stimulation or nursing
* Systemic disorders: Chest wall or thoracic spinal cord
lesions, Primary / Secondary hypothyroidism,
Adrenal insufficiency, Chronic renal failure,
Cirrhosis
* Medications:
* Psychiatric medications like Phenothiazine, Haloperidol,
Risperidone, Domperidone, Fluoexetine, Amitriptylene, MAO
inhibitors etc.,
* Antihypertensives: Alphamethyldopa, Reserpine, Verapamil
* Opiates: Heroin, Methadone, Morphine, Apomorphine
* Estrogens
* Oral contraceptives
* Cimetidine / Ranitidine
* Prolactin secreting pituitary tumors: Prolactinoma, Acromegaly
* Miscellaneous: Polycystic ovarian disease, Epileptic seizures,
Ectopic secretion of prolactin by non-pituitary tumors,
pressure / transaction of pituitary stalk, macroprolactinemia
* Idiopathic
Decreased levels
* Pituitary deficiency: Pituitary necrosis / infarction
* Bromocriptine administration
* Pseudohypoparathyroidism.
Page 8

Name: XXXXXXX Collected:21/02/12 13:46
Lab. No:12 0000 Age:44 years Gender : F Received :21/02/12 13:46
A/C Status:C Ref. By:DR. (MRS. ) XXXXXXX GARG Printed :21/02/12 18:06
Test Name Result Units Ref. Range
-------------------------------------------------------------------------
| TSH, ULTRASENSITIVE 5.589 uIU/mL (0.550 - 4.780)|
| (CLIA) |
-----------------------------------------------------------------------
Note: TSH levels are subject to circadian variation, reaching peak
levels between 2 - 4.a.m. and at a minimum between 6-10 pm.
The variation is of the order of 50%,hence time of the day
has influence on the measured serum TSH concentrations.
Clinical Use
* Diagnose Hypothyroidism and Hyperthyroidism
* Monitor T4 replacement or T4 suppressive therapy
* Quantify TSH levels in the subnormal range
Increased Levels
* Primary hypothyroidism
* Subclinical hypothyroidism
* TSH dependent Hyperthyroidism
* Thyroid hormone resistance
Decreased Levels
* Graves disease
* Autonomous thyroid hormone secretion
* TSH deficiency
REPORT AUTHORIZED BY:-
Dr. Nimmi Kansal - HOD Biochemistry
INTERIM REPORT
Tests Requested: (* = to follow)
ESTRADIOL (E2), SERUM, CALCIUM, SERUM, PHOSPHORUS, SERUM, IRON STUDIES, FSH,
LH; LUTEINISING HORMONE, PROLACTIN, SERUM, TSH ULTRASENSITIVE#,
MYCOBACTERIUM SEROLOGY PA*, COMMENTS
Page 9
 
 
Answered by Dr. Rakhi Tayal 16 minutes later
Hello XXXXXXX,

Thanks for writing again.

As I explained in my earlier reply, your serum estradiol levels are raised.

The TSH levels are also borderline raised suggestive of a mild thyroid hormone deficiency. Rest of the serum calcium, phosphorus, iron studies, FSH, LH and prolactin levels are within normal limits.

All these lab investigations need to be correlated clinically and treatment is initiated according to the clinical signs and symptoms. Close monitoring of hormonal levels are needed during the therapy.

You can consult an endocrinologist for the further management.

Hope my answer is helpful. Do accept my answer in case you do not have further queries.

Wish you good health.

Regards
Above answer was peer-reviewed by
 
Follow-up: Done tests on mid cycle. Kindly let me know whether the results are normal or out of range 1 hour later
MYCOBACTERIUM SEROLOGY PA:
IgG 0.73
IgM 0.74
IgA 701.64 U/mL

Is there a TB of Uterus?
 
 
Answered by Dr. Rakhi Tayal 43 minutes later
Hello XXXXXXX,

You have high levels of IgA levels against tubercular antigen. It is suggestive a recent onset tuberculosis infection. Since IgG and IgM levels are negative, the necessity of treatment depends on the clinical presentation.

A correlation with signs and symptoms and PCR DNA test will be diagnostic.

Hope this answer is helpful.

Regards.
Above answer was peer-reviewed by
 
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