Estradiol

Test Code
ESTRA


Alias/See Also
Epic: LAB523

17-Beta Estradiol
17 Beta Estradiol


Preferred Specimen

Specimen Type: Serum
Collection Container
Serum gel
Specimen Volume: 3 mL




Minimum Volume

0.5 mL




Instructions
Centrifuge and separate cells after clot formation and within 4 hours of collection.  Separate serum from gel within 24 hours


Transport Container
Plastic vial


Specimen Stability

Room temperature: Not defined
Refrigerated (on gel): 24 hours
Refrigerated (off gel): 7 days
Frozen: >7 days




Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Serum stored on gel >24 hours, unlabeled, mislabeled, wrong tube type, QNS, hemolysis index >500, gross lipemia (trigs >1000 mg/dl).




Methodology

Chemiluminescent Micro-particle Immunoassay (CMIA)



Setup Schedule

Daily




Report Available

Same day




Limitations

If the estradiol results are inconsistent with clinical evidence, additional testing is suggested to confirm the result.
Heterophilic antibodies in human serum can react with reagent immunoglobulins, interfering with in vitro immunoassays.

 




Clinical Significance
Estradiol is the most potent natural estrogen in humans. It regulates reproductive function in females, and, with progesterone, maintains pregnancy. Most estradiol is secreted by the ovaries (non-pregnant women), although the testes (in men) and adrenal cortex (in men and women) secrete small amounts. During pregnancy, the placenta produces most of the circulating estradiol. Normal estradiol levels are lowest at menses and into the early follicular phase (25-75 pg/mL) and then rise in the late follicular phase to a peak of 200-600 pg/mL just before the LH surge, which is normally followed immediately by ovulation. As LH peaks, estradiol begins to decrease before rising again during the luteal phase (100-300 pg/mL). If conception does not take place, estradiol falls further to its lowest levels, and menses begins shortly thereafter. If conception occurs, estradiol levels continue to rise, reaching levels of 1,000-5,000 pg/mL during the first trimester, 5,000-15,000 pg/mL during second trimester, and 10,000-40,000 pg/mL during third trimester. At menopause, estradiol levels remain low. Because the ovaries produce most estradiol in normal women, estimation of this hormone is sometimes a gauge of ovarian function. In addition, monitoring estradiol levels is important in evaluating amenorrhea, precocious puberty, the onset of menopause, and infertility in men and women. Monitoring estradiol levels is essential during in vitro fertilization, because the timing of recovery of oocytes depends on follicular development, which in turn depends on the estradiol level.


Performing Laboratory
Inova Laboratories
2832 Juniper Street
Fairfax, VA 22031




Last Updated: April 7, 2023
Last Review: N. Wolford, March 7, 2023


The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.