Progesterone test
If you want a progesterone test, the first thing to settle is the day it's taken, because the day decides what the result means. At NeoFertility in Dublin the progesterone blood test is the 7 DPO test. DPO means days past ovulation, so it's timed from your own chart, not from the calendar. It costs EUR 50 per test, it measures oestradiol alongside progesterone, and you don't need a GP referral for the consultation that comes first. Women ask for it whether or not they're trying to conceive.
Progesterone blood test: what it measures
Progesterone is the hormone your body makes after ovulation. The follicle that released the egg becomes a structure called the corpus luteum, that's a mouthful but it's simply the part that produces progesterone for the second half of your cycle. Before ovulation your progesterone is low by design. Afterwards it should climb and stay high until your period.
So a progesterone result is really a result about the ovulation that came before it. A good level says the ovulation was strong. A low level says it was weak, or that the blood was drawn at the wrong moment. Which of those it is depends entirely on the day.
Day 21 progesterone: why the day decides the answer
Day 21 is the conventional day for a progesterone test. It rests on an assumption: that you have a 28-day cycle and ovulate on day 14, which would make day 21 seven days after ovulation. Plenty of women don't. Ovulate on day 18 and a day 21 test catches you three days in, before progesterone has risen, so a normal ovulation can read as a poor one. The test is only as good as the guess behind it.
What we do is let your chart set the day. You chart with ChartNeo, we identify your peak day, and the blood is drawn on one of four days, 6 to 9 days after it. That's the 7 DPO test. We read progesterone against a target above 60 nmol/L and oestradiol above 400 pmol/L. A day 21 test is read against 30 nmol/L and only tells you whether ovulation happened. The 7 DPO test tells us how well it went. The timing method is published work co-authored by our team (Abdulla et al., Frontiers in Public Health, 2018); the 60 and 400 figures are our own clinic targets.
What a low progesterone result does and doesn't tell you
A low result at 7 DPO points to a suboptimal ovulation. That's useful, because it gives us something specific to work on.
It doesn't tell you why. A weak ovulation has several possible causes. Thyroid function and prolactin can interfere, which is why TSH and prolactin sit on the Day 3 blood profile, alongside FSH, LH and DHEA. We look at the chart, we look at the symptoms, we look at the oestradiol, and the pattern points to the cause. One result isn't a diagnosis, and it isn't a verdict on whether you can conceive. We treat the finding and recheck.
Your chart can hint at it first. A luteal phase shorter than 10 days is a marker we pay attention to (Boyle, Carpentier and Stanford, New England Journal of Medicine, 2016, PMID 26962922). Only the timed blood test measures progesterone, though.
Progesterone, PMS and PMDD
A progesterone test isn't only for couples trying to conceive. PMS and PMDD live in the second half of the cycle, and in our clinical experience women with PMS tend to show lower luteal progesterone and oestradiol than women without it. That's our clinical observation, not a published trial result. So if your mood drops, your sleep goes or your breasts ache in the fortnight before your period, the 7 DPO test is a reasonable check. Our pages on PMS and PMDD explain what we look for.
Progesterone test cost and how to arrange it
- 7 DPO blood test (oestradiol and progesterone): EUR 50 per test
- Women's health consultation, 20 minutes: EUR 100
- Fertility consultation, 45 minutes: EUR 300
You don't need a GP referral for either. The women's health consultation is the usual starting point for cycle and hormonal symptoms. If you're also trying for a baby, the fertility consultation covers the full assessment, and the progesterone test is one step in it. A woman who isn't trying to conceive can have the 7 DPO test arranged after a women's health consultation. Your result is reviewed with a doctor.
To book a consultation, contact the clinic. The 7 DPO test is arranged after the consultation and can't be booked without one. The test needs your peak day, so start charting with ChartNeo now and a few weeks of chart will give it one.
The progesterone test sits alongside the Day 3 profile on our hormone blood test page. The rest of the assessment is on our fertility test in Dublin page, and every fee is on the fertility test cost page.
Questions about the progesterone test
What are the signs of low or high progesterone?
Progesterone is meant to be high in the second half of the cycle, so a high reading after ovulation is the expected finding. The target seven days after ovulation is above 60 nmol/L, with oestradiol above 400 pmol/L, and a lower result points to a suboptimal ovulation.
On a fertility chart, premenstrual spotting and a luteal phase shorter than 10 days can point towards low progesterone, but only a timed blood test measures it.
Why is progesterone checked on day 21?
Day 21 is the conventional day for a progesterone test, and a day-21 result only shows whether ovulation happened at all. It misses the timing of the individual cycle and routinely under-reports luteal phase problems.
A test drawn seven days after ovulation, identified from the fertility chart, shows the quality of the ovulation.
What can throw off progesterone levels?
Progesterone is made by the corpus luteum, the structure that forms after ovulation, so a weak ovulation gives a low reading. Thyroid function and prolactin can interfere with ovulation, which is why TSH and prolactin sit on the Day 3 profile, alongside FSH, LH and DHEA.
Where can I get a progesterone test in Dublin?
A progesterone test timed to the cycle is arranged at the Sandyford, Dublin 18 clinic, as part of the fertility assessment. It is drawn seven days after ovulation, identified from the fertility chart, and read together with oestradiol so the result shows the quality of ovulation.
A referral is not needed.