Estrogens, Fractionated, LC/MS

Estriol may sometimes be ordered serially to help monitor a high risk pregnancy. When it is used this way, each sample should be drawn at the same time each day. An unconjugated estriol test, one that measures estriol that is not bound to a protein, is one of the components of the triple or quad screen. Decreased levels have been associated with various genetic disorders including Down syndrome, neural tube defects, and adrenal abnormalities. It is ordered during pregnancy, along with maternal alpha-fetoprotein (AFP maternal), human chorionic gonadotropin (hCG), and inhibin-A tests, to assess the risk of carrying a fetus with certain abnormalities.

Estrone is primarily derived from metabolism of androstenedione in peripheral tissues, especially adipose tissues. Individuals with obesity have increased conversion of androstenedione to Estrone leading to higher concentrations. In addition, an increase in the ratio of Estrone to Estradiol may be useful in assessing menopause in women. Estrone levels may be elevated in patients with polycystic ovarian syndrome and endometriosis. Tests may be used to aid in the diagnosis of an ovarian tumor, Turner syndrome, and hypopituitarism. In males, it may help in the diagnosis of the cause of gynecomastia or in the detection of estrogen-producing tumors.