Estrogens, Fractionated

Overview

  • EPIC Code:
  • Soft Test Code:
  • MSOT
  • Send Out Test Code:
  • 36742
Alternate Names
  • Estrogens, Fractionated, LC/MS
Included Tests

Estrone; Estradiol, Ultrasensitive; Estriol


Clinical Significance

 This panel measures the concentrations of estrone, estradiol, and estriol, the 3 main types of estrogens in serum. This panel may be useful in assessing estrogen status.

Estrogens are endogenous steroids that regulate growth and maintenance of sex organs and secondary sex characteristics in women. Estrogens also have effects on many other organ systems such as maintenance of bone density, production of liver proteins, arterial vasodilation, reduction of intraocular pressure, and influence on mood [1]. Measurements of estrogens may help evaluating sexual maturity, menstrual abnormalities, fertility abnormalities, fetal-placental health in pregnancy, tumors that excrete estrogens, and feminization syndromes in men [2].

Increased levels of estrogens may be observed in normal pregnancy, precocious puberty, hyperthyroidism, liver cirrhosis, and ovarian, testicular, and adrenal tumors. Decreased levels of estrogens may be observed in failing pregnancy, Turner syndrome, hypopituitarism, primary and secondary hypogonadism, menopause, Stein-Leventhal syndrome, and anorexia nervosa [3].

Estriol becomes the predominant estrogen only in late pregnancy. Measurements of estriol are commonly used to help screen for certain fetal abnormalities such as Down syndrome. In non-pregnant women and men, measurements of estriol have limited clinical use [2].

The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.

References
1. Gruber CJ, et al. N Engl J Med. 2002;346(5):340-352.
2. Haymond S, et al. Reproductive related disorders. In: Burtis CA, et al. eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed. Elsevier Inc; 2006:2097-2152.
3. Pagana K, et al. Mosby's Diagnostic and Laboratory Test Reference. 15th ed. Elsevier Inc; 2020:346-400.


Specimen Collection & Preparation

Specimen Requirements

2.5 mL Serum from a Red Top Tube in a Plastic Vial 


Transport And Storage

24 hours Ambient
7 days Refrigerated (Transport)
28 days Frozen


Collection Instructions

 Specify age and sex on test request form


Minimum Volume

1.5 mL Serum


Neonatal Volume

Clinical Interpretation

Reference Range:

Refer to Interpretive Results


Test Comments:

Note: Norethindrone acetate/Norethisterone acetate is known to interfere with the measurement of estrone using the Quest Diagnostics LC-MS/MS method. This test should not be used to quantitate estrone in patients taking this drug.


Methodology:
  • Chromatography / Mass Spectrometry
Clinical Significance

 This panel measures the concentrations of estrone, estradiol, and estriol, the 3 main types of estrogens in serum. This panel may be useful in assessing estrogen status.

Estrogens are endogenous steroids that regulate growth and maintenance of sex organs and secondary sex characteristics in women. Estrogens also have effects on many other organ systems such as maintenance of bone density, production of liver proteins, arterial vasodilation, reduction of intraocular pressure, and influence on mood [1]. Measurements of estrogens may help evaluating sexual maturity, menstrual abnormalities, fertility abnormalities, fetal-placental health in pregnancy, tumors that excrete estrogens, and feminization syndromes in men [2].

Increased levels of estrogens may be observed in normal pregnancy, precocious puberty, hyperthyroidism, liver cirrhosis, and ovarian, testicular, and adrenal tumors. Decreased levels of estrogens may be observed in failing pregnancy, Turner syndrome, hypopituitarism, primary and secondary hypogonadism, menopause, Stein-Leventhal syndrome, and anorexia nervosa [3].

Estriol becomes the predominant estrogen only in late pregnancy. Measurements of estriol are commonly used to help screen for certain fetal abnormalities such as Down syndrome. In non-pregnant women and men, measurements of estriol have limited clinical use [2].

The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings.

References
1. Gruber CJ, et al. N Engl J Med. 2002;346(5):340-352.
2. Haymond S, et al. Reproductive related disorders. In: Burtis CA, et al. eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed. Elsevier Inc; 2006:2097-2152.
3. Pagana K, et al. Mosby's Diagnostic and Laboratory Test Reference. 15th ed. Elsevier Inc; 2020:346-400.


Production Schedule

Sites Performed
  • Quest - Chantilly to San Juan Capistrano
Days Performed
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Departments
  • Sendouts - Miscellaneous
Turn Around Time

1 to 4 days


Coding & Compliance

CDM

00913333


CPT Coding

82671