What exactly is PdG and why do I need to test my levels?

What exactly is PdG?

Progesterone is the hormone released after ovulation and is required to reach certain levels in order to support a pregnancy. Pregnanediol, or PdG for short, is the main urine metabolite of progesterone. Several studies have shown that serum (blood) levels of progesterone and urine levels of pregnandiol are highly correlative (Roos et al (2015) Monitoring the menstrual cycle: Comparison of urinary and serum reproductive hormones referenced to true ovulation, The European Journal of Contraception & Reproductive Health Care). Therefore, Proov tests are a great non-invasive way to track progesterone levels at home after ovulation (also known as the luteal phase of the menstrual cycle).

Why should I be testing my PdG levels?

A few articles were just published that studied the benefits of PdG testing during the luteal phase of the menstrual cycle.
1) Progesterone is secreted in waves, creating spikes in serum progesterone levels, therefore tracking daily urine PdG levels is a better luteal phase diagnostic tool than a single serum progesterone level (Alliende et al Front. Public Health, 31 May 2018)
2) Follicles contain the maturing egg and small sized follicles are associated with poor luteal phase quality, which can lead to infertility and miscarriage. Poor luteal phase was shown as normal PdG levels followed by low levels of PdG. (Abdulla et al Front. Public Health, 24 May 2018)
3) Low PdG levels followed by normal PdG levels is normal and not a sign of an abnormal luteal phase since some women take longer to produce progesterone.(Abdulla et al Front. Public Health, 24 May 2018)
4) Recent research points out the inaccuracy of using LH tests by themselves to detect ovulation and suggests they could be utilized along with PdG in-home tests to increase accuracy (Leiva et al Urinary luteinizing hormone tests: which concentration threshold best predicts ovulation? Front Public Health (2017) 5:320.)

How do I monitor my PdG levels?

Proov tests are in-home test strips that allow women to monitor PdG levels in their urine during their luteal phase of their menstrual cycle. The threshold of a positive test is 5ug/ml PDG (equivalent to 6-8 ng/ml serum progesterone). Most fertility specialists consider serum progesterone levels of >5ng/ml to be confirmatory for ovulation and >10 ng/ml of serum progesterone to be required to support a successful pregnancy