Luteinizing Hormone (LH), Serum
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
An adjunct in the evaluation of menstrual irregularities
Evaluating patients with suspected hypogonadism
Diagnosing pituitary disorders
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Luteinizing Hormone (LH), S
Interstitial Cell Stimulating Hormone
Luteinizing Hormone (LH)
Luteinizing Hormone (LH)
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Preferred: Serum gel
Acceptable: Red top
Specimen Volume: 0.6 mL
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Mild OK; Gross reject
Mild OK; Gross OK
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
|Serum||Refrigerated (preferred)||7 days|
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Luteinizing hormone (LH) is a glycoprotein hormone consisting of 2 noncovalently bound subunits (alpha and beta). The alpha subunit of LH, follicle-stimulating hormone (FSH), thyroid stimulating hormone (TSH), and human chorionic gonadotropin (hCG) are identical and contain 92 amino acids. The beta subunits of these hormones vary and confer the hormones' specificity. LH has a beta subunit of 121 amino acids and is responsible for interaction with the LH receptor. This beta subunit contains the same amino acids in sequence as the beta subunit of hCG and both stimulate the same receptor, however, the hCG beta subunit contains an additional 24 amino acids, and the hormones differ in the composition of their sugar moieties. Gonadotropin-releasing hormone from the hypothalamus controls the secretion of the gonadotropins, FSH and LH, from the anterior pituitary.
In both males and females, LH is essential for reproduction. In females, the menstrual cycle is divided by a midcycle surge of both LH and FSH into a follicular phase and a luteal phase. This "LH surge" triggers ovulation thereby not only releasing the egg, but also initiating the conversion of the residual follicle into a corpus luteum that, in turn, produces progesterone to prepare the endometrium for a possible implantation. LH is necessary to maintain luteal function for the first 2 weeks. In case of pregnancy, luteal function will be further maintained by the action of hCG (a hormone very similar to LH) from the newly established pregnancy. LH supports thecal cells in the ovary that provide androgens and hormonal precursors for estradiol production. LH in males acts on testicular interstitial cells of Leydig to cause increased synthesis of testosterone.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
0-14 days: not established
15 days-10 years: 0.3-2.8 IU/L
11 years: 0.3-1.8 IU/L
12 years: 0.3-4.0 IU/L
13 years: 0.3-6.0 IU/L
14 years: 0.5-7.9 IU/L
15-16 years: 0.5-10.8 IU/L
17 years: 0.9-5.9 IU/L
> or =18 years: 1.8-8.6 IU/L
Stage l: 0.3-2.7 IU/L
Stage ll: 0.3-5.1 IU/L
Stage lll: 0.3-6.9 IU/L
Stage lV: 0.5-5.3 IU/L
Stage V: 0.8-11.8 IU/L
*Puberty onset occurs for boys at a median age of 11.5 (+/- 2) years. For boys there is no proven relationship between puberty onset and body weight or ethnic origin. Progression through Tanner stages is variable. Tanner stage V (adult) should be reached by age 18.
0-14 days: not established
15 days-3 years: 0.3-2.5 IU/L
4-6 years: < or =1.9 IU/L
7-8 years: < or =3.0 IU/L
9-10 years: < or =4.0 IU/L
11 years: < or =6.5 IU/L
12 years: 0.4-9.9 IU/L
13 years: 0.3-5.4 IU/L
14 years: 0.5-31.2 IU/L
15 years: 0.5-20.7 IU/L
16 years: 0.4-29.4 IU/L
17 years: 1.6-12.4 IU/L
> or =18 years
Follicular: 2.1-10.9 IU/L
Midcycle: 20.0-100.0 IU/L
Luteal: 1.2-12.9 IU/L
Postmenopausal: 10.0-60.0 IU/L
Stage I: < or =2.0 IU/L
Stage II: < or =6.5 IU/L
Stage III: 0.3-17.2 IU/L
Stage IV: 0.5-26.3 IU/L
Stage V: 0.6-13.7 IU/L
*Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for girls at a median age of 10.5 (+/- 2) years. There is evidence that it may occur up to 1 year earlier in obese girls and in African American girls. Progression through Tanner stages is variable. Tanner stage V (adult) should be reached by age 18.
Pediatric ranges derived for DXI method from analytic comparison to reference method in: Elmlinger MW, Kuhnel W, Ranke MB: Reference ranges for serum concentrations of lutropin (LH), follitropin (FSH), estradiol (E2), prolactin, progesterone, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), cortisol and ferritin in neonates, children and young adults. Clin Chem Lab Med 2002;40(11):1151-1160
In both males and females, primary hypogonadism results in an elevation of basal follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels.
Postmenopausal LH levels are generally >40 IU/L. (Note: FSH is the preferred test to confirm menopausal status.)
FSH and LH are generally elevated in:
- Primary gonadal failure
- Complete testicular feminization syndrome
- Precocious puberty (either idiopathic or secondary to a central nervous system lesion)
- Primary ovarian hypodysfunction in females
- Polycystic ovary disease in females
- Primary hypogonadism in males
LH is decreased in:
- Primary ovarian hyperfunction in females
- Primary hypergonadism in males
FSH and LH are both decreased in failure of the pituitary or hypothalamus.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
No clinically significant cross-reactivity has been demonstrated with follicle-stimulating hormone, thyroid stimulating hormone, or human chorionic gonadotropin.
Some patients who have been exposed to animal antigens, either in the environment or as part of treatment or imaging procedures, may have circulating antianimal antibodies present. These antibodies may interfere with the assay reagents to produce unreliable results.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Kaplan LA, Pesce AJ: The gonads. In Clinical Chemistry: Theory, Analysis, and Correlation. Third edition. Edited by SC Kazmierczak. St. Louis, MO, Mosby-Year Book, Inc, 1996, p 894
2. Dumesic DA: Hyperandrogenic anovulation: a new view of polycystic ovary syndrome. Postgrad Ob Gyn 1995;15:1-5
Method Description Describes how the test is performed and provides a method-specific reference
The instrument used is the Beckman Coulter Unicel DXI 800. The Access hLH assay is a sequential 2-step immunoenzymatic sandwich assay. Sample is added to a reaction vessel, along with paramagnetic particles coated with goat antimouse:mouse anti-hLH complexes and TRIS buffered saline with protein. The hLH binds to the immobilized mouse anti-hLH on the solid phase. Materials bound to the solid phase are held in a magnetic field, while unbound materials are washed away. Alkaline phosphatase conjugated goat anti-hLH is then added, which binds to the previously bound hLH on the particles. A second separation and wash step removes unbound conjugate. The chemiluminescent substrate Lumi-Phos 530 is added to the vessel and light generated by the reaction is measured with a luminometer. The light production is directly proportional to the concentration of hLH in the sample. The amount of analyte in the sample is determined from a stored multipoint calibration curve.(Beckman Assay Manual: Beckman Coulter Inc, Fullerton, CA, 2010)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday 5 a.m. – 12 a.m., Saturday 6 a.m. – 6 p.m.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Same day/1 day
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
|Result ID||Reporting Name||LOINC Code|
|LH||Luteinizing Hormone (LH), S||10501-5|