Luteinizing Hormone (LH), Serum
| Luteinizing Hormone (LH), Serum | | | |
| Number | | 004283 |
| CPT | | 83002 (per specimen) |
| Related Information | | Follicle-Stimulating Hormone (FSH), Serum |
| Synonyms | | ICSH ; Interstitial Cell Stimulating Hormone ; LH |
| Special Instructions | | State patient's age and sex on the request form. |
| Specimen | | Serum |
| Volume | | 1 mL |
| Minimum Volume | | 0.3 mL (Note: This volume does not allow for repeat testing.) |
| Container | | Red-top tube or gel-barrier tube |
| Collection | | If a red-top tube is used, transfer separated serum to a plastic transport tube. |
| Storage Instructions | | Refrigerate |
| Reference Interval | | See table.1,2
| Age | Male
(mIU/mL) | Female
(mIU/mL) | | 0-23 mo | 0.5-1.9 | 0.0-0.5 | | 2-10 y | 0.0-0.5 | 0.0-0.5 | | 11-20 y | 0.5-5.3 | 0.5-9.0 | | 20-70 y | 1.5-9.3 | 0.0-76.3 | | 70-100 y | 3.1-34.6 | 5.0-52.3 | | | | Follicular: 1.9-12.5 | | | | Midcycle: 8.7-76.3 | | | | Luteal: 0.5-16.9 | | | | Pregnant: 0.0-1.5 | | | | Postmenopausal: 15.9-54.0 | | | | Contraceptives: 0.7-5.6 | | Tanner Stage | | I | 0.0-3.6 | 0.0-0-3 | | II | 0.3-4.8 | 0.1-4.1 | | III | 0.6-6.3 | 0.2-9.1 | | IV & V | 0.6-7.8 | 0.5-15 |
|
| Use | | The primary clinical use of LH measurement is in evaluating the normalcy of hypothalamic-pituitary-gonadal axis. Measurement of serum gonadotropin levels will allow for distinguishing between primary gonadal failure and deficient gonadal stimulation. LH measurement may also be of clinical importance because growth hormone and LH are frequently the first hormones to be affected by pituitary disease. The serum analysis of LH has also been found to be very useful in the diagnosis and treatment of infertility in women. |
| Limitations | | Secretion of both LH and FSH is pulsatile, in response to the normal intermittent release of gonadotropin releasing hormone (GnRH). While both are pulsatile, LH exhibits a circadian rhythm while FSH does not.3 In addition, in females both FSH and LH vary over the course of the menstrual cycle, with peaks at time of ovulation. Thus, interpretation of a single determination may be difficult. Only 77% of patients with polycystic ovary syndrome have increase of LH.4 Increased LH with normal or low FSH may occur with obesity, hyperthyroidism, and in liver disease.5 Normal LH and FSH levels can occur in hypoestrogenic patients. FSH and LH within normal range can occur with CNS/pituitary failure.6 |
| Methodology | | Immunochemiluminometric assay (ICMA) |
| Additional Information | | FSH and LH are glycoprotein pituitary hormones which have unique β-subunits, and α-subunits in common with TSH and hCG. They are under complex regulation by hypothalamic GnRH and by gonadal sex hormones, estrogen and progesterone in females, and testosterone in males. On the simplest level FSH and LH are high in conditions in which sex hormones cannot be elaborated, and low in conditions of primary pituitary dysfunction. High concentrations of LH (during the follicular phase) in patients with polycystic ovary syndrome interfere with conception, and may contribute to early pregnancy loss in these patients. In males, LH has been called interstitial cell stimulating hormone (ICSH) because of its effect on testosterone production by Leydig cells. This is necessary for normal maturation of spermatozoa. |
| Footnotes | | - Soldin SJ, Morales A, Albalos F, et al, “Pediatric Reference Ranges on the Abbott IMx for FSH, LH, Prolactin, TSH, T4, T3, Free T4, Free T3, T-Uptake, IgE, and Ferritin,” Clin Biochem, 1995, 28(6):603-6.
- Tietz NW, ed, Clinical Guide to Laboratory Tests, 3rd ed, Philadelphia, PA: WB Saunders Co, 1995, 410.
- Dunkel L, Alfthan H, Stenman UH, et al, “Developmental Changes in 24-Hour Profiles of Luteinizing Hormone and Follicle-Stimulating Hormone From Prepuberty to Midstages of Puberty in Boys,” J Clin Endocrinol Metab, 1992, 74(4):890-7.
- Baker ER, “Diagnosis of Polycystic Ovary Syndrome,” JAMA, 1983, 250:671 (letter).
- Plymate SR, “Diagnosis of Polycystic Ovary Syndrome,” JAMA, 1983, 250:671 (letter).
- Speroff L, Glass RH, and Kase NG, Clinical Gynecologic Endocrinology and Infertility, 4th ed, Baltimore, MD: Williams & Wilkins, 1989
|
| References | | Findling JW and Tyrrell JB, “Anterior Pituitary and Somatomedins: I. Anterior Pituitary,” Basic and Clinical Endocrinology, Greenspan FS and Forsham PH, eds, Los Altos, CA: Lange Medical Publications, 1983, 38-88. Kossoy LR, Hill GA, Parker RA, et al, “Luteinizing Hormone and Ovulation Timing in a Therapeutic Donor Insemination Program Using Frozen Semen,” Am J Obstet Gynecol, 1989, 160(5 Pt 1):1169-72. Nippoldt TB, Reame NE, Kelch RP, et al, “The Roles of Estradiol and Progesterone in Decreasing Luteinizing Hormone Pulse Frequency in the Luteal Phase of the Menstrual Cycle,” J Clin Endocrinol Metab, 1989, 69(1):67-76. |
|