At present, there is no complete and unified value for the determination of endocrine sex hormones in obstetrics and gynecology in China, and due to the different sources of various reagents, methods of measurement, data calculation and units used, even for the same hormone specimen, the results obtained by each laboratory are not exactly the same. The following reference values for sex hormone examination are gathered from various professional books and magazines at home and abroad, hoping to provide useful references for all colleagues. I. General knowledge of sex hormone examination You cannot use sex hormone drugs (including progesterone and estrogen) at least one month before checking basic sex hormones, otherwise the results are unreliable (except for sex hormones that need to be rechecked after treatment). Sex hormones can be checked at any time of menstruation, and the normal value varies for each period. However, the diagnosis and treatment of infertility must be informed about the basal sex hormone levels. The first step is to choose the 2nd to 5th day of menstruation for the examination, called basal sex hormone levels, which are best measured on the 3rd day. To be sure that it is the 3rd day of menstruation, it is enough to check sex hormone 5, which can be done without checking progesterone, which should be checked during the luteal phase (21 days of menstruation or 7 days after ovulation); however, if you are not sure whether vaginal bleeding is menstrual, you should check 6 items to prevent misdiagnosis (according to P data, you can roughly determine the period of menstrual cycle). In cases of scanty menstruation and amenorrhea, a negative urine pregnancy test, absence of ≥10mm follicles in both ovaries on vaginal ultrasound, and EM thickness of 5mm can also be done as basal status. The basic sex hormone laboratory test should be looked at in this way: the normal value of basic LH and FSH is 5 to 10 IU/L, and the normal value of basic E2 is 25 to 50 pg/ml (the results of these three items cannot look at the reference value on the laboratory test, and should be according to this standard); PRL and T can be compared with the reference value of the laboratory test in the hospital, and the normal value of P is shown after. Second, the clinical significance of sex hormone examination (a) FSH and LH: the basic value of 5-10IU/L normal menstrual cycle, early follicular (2-3 days of menstruation) blood FSH, LH are maintained at a low level, before ovulation rapidly rise, LH up to 3-8 times the basic value, up to 160IU/L or even higher, while FSH only about 2 times the basic value, rarely 30IU / L, after ovulation After ovulation, FSH and LH rapidly return to the follicular phase level. FSH and LH levels in the early follicular phase can be monitored to determine the function of the gonadal axis, and FSH is more valuable than LH in determining ovarian potential. 1, Ovarian failure: Basal FSH 40IU/L, elevated LH or 40IU/L, as hypergonadotropic (Gn) amenorrhea, i.e. ovarian failure; if it occurs before the age of 40, it is called premature ovarian failure (POF). 2, Basal FSH and LH are 5IU/L for low Gn amenorrhea, suggesting hypothalamic or pituitary hypofunction, and the distinction between the two needs to be made with the help of gonadotropin-releasing hormone (GnRH) test. 3. Dysfunctional ovarian reserve (DOR): Basal FSH/LH2-3.6 indicates DOR (FSH can be in the normal range), which is an early manifestation of ovarian dysfunction and often suggests that the patient is not responding well to superovulation (COH), and the COH protocol and Gn dose should be adjusted in time to improve ovarian responsiveness and obtain the desired pregnancy rate. Because elevated FSH/LH only reflects DOR, not decreased fertility, ideal pregnancy rates can still be obtained once a period of ovulation is obtained. 4. Basal FSH 12IU/L, retested in the next cycle, 12 consecutive IU/L suggests DOR. 5. Polycystic ovary syndrome (PCOS): Basal LH/FSH 2 to 3, which can be used as the main indicator for the diagnosis of PCOS (Basal LH level 10IU/L is considered elevated, or LH maintains normal level, while the relatively low level of basal FSH creates an elevated LH to FSH ratio ). 6. Checking 2 times basal FSH>20IU/L can be considered as insidious stage of premature ovarian failure, suggesting possible amenorrhea after 1 year. (II) P: basal value is generally <1ng/ml Under normal conditions, blood P during follicular phase has been at a low level, average 0.6~1.9nmol/L, generally <10nmol/L (3.15ng/ml); when LH peak appears before ovulation, P secretion starts to increase, after ovulation ovarian corpus luteum produces a large amount of P, blood P concentration rises rapidly; when corpus luteum matures (6~8 days after LH peak At the time of luteal maturation (6~8 days after LH peak), blood P concentration reaches a peak of 47.7~102.4nmol/L (15~32.2ng/ml) or higher, and then decreases continuously, reaching the lowest level in the premenstrual period. The P content of peripheral blood in the whole corpus luteum changes parabolicly. 1.Determination of ovulation: P>16nmol/L (5ng/ml) in the mid-luteal phase (21st day of menstruation for women with a 28-day menstrual cycle) suggests ovulation, 16nmol/L (5ng/ml) suggests anovulation. 2.Diagnosis of luteal insufficiency (LPD): P32nmol/L (10ng/ml) at mid-luteal phase, or P measured 3 times on the 5th, 7th and 9th day after ovulation, the total sum of 95.4nmol/L (30ng/ml) is LPD; or P47.7nmol/L (15ng/ml) before 10th week of pregnancy is the criterion for the diagnosis of LPD. 3. To determine the prognosis of in vitro fertilization-embryo transfer (IVF-ET): pre-ovulatory P level can estimate the prognosis of IVF-ET. P ≥ 3.18 nmol/L (1.0 ng/ml) on the day of myeloablative HCG should be considered elevated, with decreased implantation and clinical pregnancy rates, and P 4.77 nmol/L (1.5 ng/ml) suggesting premature luteinization. In IVF-ET long protocol ovulation promotion, even if there is no elevation of LH concentration on the day of intramuscular HCG injection, if P(ng/ml)×1000/E2(pg/ml) >1, it indicates premature follicular luteinization and the clinical pregnancy rate is significantly lower in this group of patients. Premature luteinization is also a manifestation of DOR. 4. Identification of ectopic pregnancy: blood P levels in ectopic pregnancy are low, with most patients having a blood P of 47.7 nmol/L (15ng/ml). Only 1.5% of patients have ≥79.5 nmol/L (25ng/ml). In normal intrauterine pregnancies P is 79.5 nmol/L in 90% and 47.6 nmol/L in 10%. blood P levels can be used as a reference in the differential diagnosis of intrauterine versus ectopic pregnancy. (iii) E2: basal value is 25-45pg/ml In normal menstrual cycle, E2 is about 183.5pmol/L (50pg/ml) in early follicular phase, reaches the first peak before ovulation, up to 917.5-1835pmol/L (250-500pg), decreases rapidly after ovulation, and forms the second peak in luteal phase, about 458.8pmol/L ( 124.80pg), after maintaining for a period of time, the luteal atrophy drops to the early follicular phase level, i.e. the 3rd day of menstruation should be 91.75~183.5pmol/ml (25~50pg/ml). 1, Basal E2>165.2~293.6pmol/L (45~80pg/ml), regardless of age and FSH, indicates decreased fertility. 2, When basal E2≥367pmol/L(100pg/ml), ovarian response is even worse, even if FSH15IU/L, pregnancy is not possible. 3. Indicators for monitoring follicle maturation and ovarian hyperstimulation syndrome (OHSS) ①Promoting follicle expulsion: when follicle ≥18mm and blood E2 reaches 1100pmol/L (300pg/ml) during ovulation promotion therapy, stop HMG and inject HCG 10000IU on the same day or 24-36 hours after the last HMG injection. ②E23670pmol/L ( 1000pg/ml), OHSS usually does not occur. ③E29175pmol/L (2500pg/ml), a high risk factor for OHSS, timely discontinuation or reduction of HMG dosage and disabling HCG to support luteal function can avoid or reduce the occurrence of OHSS. (iv) PRL PRL is synthesized and secreted by eosinophilic PRL cells of the pituitary gland. PRL secretion is unstable, emotions, exercise, sexual intercourse, hunger and eating can affect its secretion status, and there are small fluctuations with the menstrual cycle, with a The secretion of PRL increases within a short period of time after sleep, and is higher in the afternoon than in the morning. Therefore, according to this rhythmical secretion characteristic, blood should be drawn on an empty stomach at 9-10 a.m. If PRL is significantly elevated, it can be determined in one test; if PRL is mildly elevated, a second test should be performed, and hyperprolactinemia (HPRL) should not be easily diagnosed and abused with bromocriptine treatment. PRL ≥ 25ng/ml or higher than the normal value of this unit test is HPRL. PRL 50ng/ml, about 20% have prolactinoma. PRL100ng/ml, about 50% have a prolactinoma and can be selectively done with pituitary CT or MRI. PRL200ng/ml, often with microadenoma, must be done with pituitary CT or MRI. Reduced PRL: Silhan syndrome, use of anti-PRL drugs such as bromocriptine, levodopa, VitB6, etc. (v) T is mildly to moderately elevated in patients with testosterone COS; ovarian or adrenal gland with androgen-secreting tumors and hirsutism T is elevated.