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Hormones

Progesterone and fertility: what the value says about ovulation and pregnancy

According to the NVKC, progesterone is a hormone that readies the womb lining after ovulation for the implantation of a possible fertilised egg. Later in pregnancy, according to the NVKC, it is mainly the placenta that makes progesterone.

If progesterone rises insufficiently in early pregnancy, that can be an extra indication of an ectopic pregnancy or an early miscarriage, according to the NVKC. Only a blood test shows whether progesterone rises enough in early pregnancy.

For the luteal phase, Certe gives 13.1 to 46.3 nmol/l in its notes and Unilabs 3.8 to 50.6 nmol/l.

Doctor's Assessment Included

Progesterone is a hormone made mainly in the ovaries after ovulation, which prepares the lining of the womb for a fertilised egg. The normal value depends on the cycle phase and differs widely between laboratories: the lower limit in the luteal phase, the second half of the cycle after ovulation, is 3.8 nmol/l at Unilabs, 5.82 at Star-SHL, 10.6 at Diagnostiek voor U and 13.1 at Certe.

  • According to the NVKC, a progesterone result that fits the luteal phase is a sign that ovulation has taken place.
  • The UK NICE guideline advises measuring progesterone midway through the second half of the cycle: on day 21 of a 28-day cycle, and later in a longer cycle.
  • In men progesterone is low; Unilabs uses up to 1.6 nmol/l.

Reference Ranges

Reference ranges by group, in nmol/l
Female · Follicular < 0,62 nmol/l
0,62
Female · Ovulatory 0,18–13,2 nmol/l
0,18 13,2
Female · Luteal 13,1–46,3 nmol/l
13,1 46,3
Female · Postmenopausal < 0,4 nmol/l
0,4
0,18 46,3 nmol/l

Package-insert value: 5th-95th percentile per subgroup (n = 147 men; 142 postmenopausal; 85 follicular; 81 ovulation; 85 luteal). Values below the detection limit of the test (0.159 nmol/l) are reported as "< 0.159"; in men, postmenopausal women and the follicular phase the 5th percentile lies below that, so there is no lower limit. The timing of the draw determines the result: a mid-luteal progesterone measurement belongs about 7 days before the expected period (cycle length minus 7 days), not on a fixed day 21. In a 35-day cycle, day 21 is still follicular. Just before the period, progesterone falls again. A hormone reference value is assay-specific; these values apply to the Roche Elecsys method.

Source: Roche Diagnostics Reference population: Roche reference cohort (Elecsys Progesterone III package insert)

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Check your own value

Progesterone: what Dutch laboratories use

Reference ranges by group, in nmol/l
Star-shl · Female · follicular phase 0.181–2.840 nmol/l
0.181 2.84
Star-shl · Female · ovulatory phase 0.385–38.100 nmol/l
0.385 38.1
Star-shl · Female · luteal phase 5.82–75.90 nmol/l
5.82 75.9
Star-shl · Female · a limit, not a range · after menopause < 0.401 nmol/l
0.401
Unilabs · Female · 14 years and older · follicular phase 0–1 nmol/l
0 1
Unilabs · Female · 14 years and older · luteal phase 3.8–50.6 nmol/l
3.8 50.6
Unilabs · Female · 14 years and older · after menopause 0.0–0.6 nmol/l
0 0.6
Certe · Female · a limit, not a range · follicular phase < 0.62 nmol/L
0.62
Certe · Female · ovulatory phase 0.18–13.20 nmol/L
0.18 13.2
Certe · Female · luteal phase 13.1–46.3 nmol/L
13.1 46.3
Certe · Female · 50 years and older 0.1–0.5 nmol/L
0.1 0.5
Diagnostiek voor U · Female · a limit, not a range · follicular phase < 4.5 nmol/L
4.5
Diagnostiek voor U · Female · luteal phase 10.6–81.0 nmol/L
10.6 81
Diagnostiek voor U · Female · a limit, not a range · after menopause < 2.3 nmol/L
2.3
0 89.1 nmol/l

Source: Star-shl

Source: Unilabs

Source: Certe

Source: Diagnostiek voor U

Each value as the laboratory itself publishes it, retrieved in 2026.

Progesterone: what this test measures

The progesterone test measures in nanomoles per litre (nmol/l) how much progesterone is in the blood, and in its notes Certe puts days to the phases: follicular day 1 to 12, ovulation day 13 to 15 and luteal day 16 to 28.

Progesterone: why this value matters

According to the NVKC, a progesterone result that fits the luteal phase is an indication that ovulation has taken place. If progesterone exceeds a certain concentration at any point in the second half of the cycle, according to the NVKC usually around 40 to 50 nmol/l, the NVKC calls ovulation demonstrated.

Progesterone: how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Which test
Progesterone Test · €69,- · Ovulation Confirmation · €69,- · Hormones Women · €139,- · IVF Blood Test Complete (Women) · €495,-
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

Progesterone: how to prepare

  1. Do you have a cycle? Pick the right day

    Required

    If you have a menstrual cycle, have the draw 7 days before your next expected period; if that cycle is irregular, repeat weekly until your period starts. Without a cycle, any day works.

  • Water is always fine. Drink as usual beforehand, it makes the draw easier.
  • Take your usual medication, unless your own doctor told you otherwise.

Progesterone: when is testing worthwhile?

According to the NVKC, progesterone in early pregnancy is measured to detect a possible ectopic pregnancy or early miscarriage.

Progesterone: symptoms of a high or low value

Low Levels

When progesterone does not rise and fall in the cycle according to the normal pattern, that may point to an absent ovulation, an absent period or both, according to the NVKC. According to Thuisarts, ovulating less often or not at all is one of the possible reasons that getting pregnant takes longer than a year.

High Levels

A high progesterone fits a pregnancy, in which progesterone is between 50 and 1440 nmol/l according to the NVKC, and with twins or more it rises extra strongly, according to the NVKC.

Progesterone: causes of a low or high value

What lowers the value

  • No ovulation

    If progesterone does not rise and fall through the cycle in the normal pattern, this can mean there has been no ovulation, no menstruation, or both.

  • Heavy exercise, underweight or overweight

    The chance of ovulation can be lower with very heavy exercise, rapid weight loss, being underweight or being overweight, and without ovulation progesterone stays low in the second half of the cycle.

  • Blood taken on another cycle day

    Progesterone measured before the second half of the cycle is lower than the luteal-phase value; the UK NICE guideline advises measuring midway through the second half, on day 21 of a 28-day cycle and later in a longer cycle, for example on day 28 of a 35-day cycle.

  • After menopause

    After menopause progesterone is low; Star-SHL then uses below 0.401 nmol/l.

  • An early pregnancy that is not progressing

    If progesterone does not rise enough in early pregnancy, this can be an extra sign of an ectopic pregnancy or an early miscarriage.

What raises the value

  • After ovulation

    Progesterone follows a fixed pattern through the cycle, peaking in the second half, the luteal phase, after ovulation.

  • Pregnancy

    During pregnancy progesterone rises and lies between 50 and 1440 nmol/l, with especially strong rises in a multiple pregnancy.

  • Progesterone given as medicine

    Progesterone given as a medicine, for example vaginally during fertility treatment, is measured in the blood.

Progesterone: lifestyle and this value

With a progesterone result in a fertility investigation, your GP or gynaecologist is the point of contact, with the cycle day of the blood draw alongside it. According to Thuisarts, stress or heavy work can make the chance of ovulation smaller.

Progesterone: frequently asked questions

Is luteal phase deficiency a cause of infertility?

Luteal phase deficiency has not been proven as an independent cause of infertility or recurrent miscarriage, according to a 2026 ASRM committee opinion, although according to that opinion progesterone is important for implantation and early embryonic development. According to the ASRM, there is disagreement about the ways to diagnose it.

Is progesterone from a vaginal treatment measured too?

In a 2021 study of frozen embryo transfer after artificial preparation of the womb lining, in which the body makes no progesterone of its own, the progesterone value in the blood reflected how much vaginally given progesterone was absorbed.

What is a normal progesterone in pregnancy?

For progesterone in pregnancy, Certe gives 35 to 141 nmol/l in the first trimester, 81 to 265 nmol/l in the second and 187 to 679 nmol/l in the third trimester in its notes.

Progesterone: sources

  1. Roche Diagnostics. Elecsys Progesterone III, Method Sheet 07027699500 V 9.0, 2024-10 (CE). Material 07027699190 (cobas e 402 / e 801). Verwachte waarden: 5e-95e percentiel ("based on a central 90 % interval"). (retrieved 2026) elabdoc-prod.roche.com
  2. Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
  3. Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
  4. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  5. Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
  6. NVKC, Alles over testen: Progesteron, allesovertesten.nl, geraadpleegd 2026-10-06 (retrieved 2026) allesovertesten.nl
  7. NHG, Thuisarts.nl: Ik wil onderzoeken waarom ik nog niet zwanger ben, geraadpleegd 2026-10-06 (retrieved 2026) thuisarts.nl
  8. NICE guideline NG257, Fertility problems: assessment and treatment, published 31 March 2026, consulted 2026-10-06. (retrieved 2026) nice.org.uk
  9. Gao H, et al. Strengthened luteal phase support for patients with low serum progesterone on the day of frozen embryo transfer in artificial endometrial preparation cycles. Reprod Biol Endocrinol 2021;19:60. (retrieved 2026) pmc.ncbi.nlm.nih.gov

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