# Hyperprolactinaemia?



## Rave77

Hi, I am 34 years old TTC for 2 years (as of New Years Eve). 

Sorry-this does go on a bit....

We saw our GP earlier this year and he arranged for semen analysis for my husband and told us all was well so referred us to the fertility clinic.

My initial baseline scan was fine, no abnormalities detected. Initial bloods showed progesterone was "a little low, but not abnormal" and Prolactin "a little high (around 570) but nothing to worry about unless its over 1000".

Skipping back 10 years or so ago, I developed galactorrhea, saw a breast specialist who told me my prolactin levels were 480, again told "a little high but not abnormal" I was assured I was fine and would "make a great wet nurse". Charming. I mentioned this to my fertility nurse who arranged for a repeat of the prolactin test. The result was even higher- in the 700s. However I was still told that this was nothing of importance, probably due to stress and they wouldn't investigate it further.

My consultant also requested the results of the semen analysis and then told us that the quantity and motility was fine but that the quality was poor, and suggested my husband take Centrum supplements containing zinc.

I then started on Clomid (I feel this was a "lets just try it and see approach"), taken on cycle days 1-5 earlier this month. My follicular tracking scan showed only one follicle and i was told it was very small @ 10mm on day 10.

I have today recieved the results of my 21 day progesterone test which was low @ 4. I am now on day 30 and AF hasnt arrived so they have asked me to have another progesterone test tomorrow, just incase I have ovulated late.The next step is to increase the Clomid dose.

Now I am not a persistent "googler", but I am a health professional myself and I have found some articles regarding hyperprolactinaemia, infertility and Clomid failure due to hyperprolactinaemia and find it odd that the clinic don't seem to be investigating this path further.

My instinct is to suspend the Clomid for now and investigate the hyperprolactinaemia before making any further treatment plans. 

Any thoughts or comments on this?


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## MIKA33

Hi. I'm also 34 and been TTC for 3 years (3 unsuccessful ICSI)

About two and a half years ago I started with galactorrhea and had my prolactin levels tested which showed them to be high. I'm away at the moment so can't check the results but I don't remember them being massively high. However, I was still referred to an endocrinologist to investigate what was causing the hyperprolactinaemia. She arranged an MRI which showed I had a very small growth on my pituitary gland which was causing the prolactin levels to increase and I was put on Bromocriptine which I've been taking ever since. Despite the fact that the growth was tiny and my levels weren't massively high, I still had to have a very high dose of Bromocriptine to get my prolactin levels back to normal. They said increased prolactin levels can stop ovulation although we have since discovered that there are male factor infertility issues which would mean a natural conception is unlikely. Neither my consultant nor my endocrinologist will decrease or take me off the Bromocriptine as they say that if my prolactin levels increase it could jeopordise our ongoing IVF treatments. I am surprised that you haven't been referred to an endocrinologist and if it were me I would probably push for a referral. Once I am back home from holiday in about a week I'll check to see what my results were and let you know.


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## agate

it does sound like your docs haven't followed normal procedure - althought I don't know what the lab you used quote for the normal range for PRL - it does vary between labs, and you wouldn't expect to treat it unless you are outside the normal range. 

if you are TTC and your PRL is high, first they should exclude an obvious cause for the high PRL - if necessary a scan of the pituitary gland to make sure there isn't a benign tumour unless they are sure your levels aren't high enough for it to be that, then its normal to put you on a PRL inhibiting drug like bromocriptine or cabergoline - because otherwise, your ovulation may be affected leading to anovulation or luteal phase deficit. 

problems with prolactin can sometimes be associated with problems with your thyroid - so, if you can get your GP to run your TSH and FT4 that might be worth doing too - and maybe ask for your antithyroid antibodies to be run at the same time.

best of luck

A x


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## Rave77

Thank you for your reply, I am going to ask for them to investigation the elevate prolactin before undertaking another cycle of Clomid, as far as I am concerned you should provide a treatment without first giving the correct diagnosis.

Speaking of thyroid problems, I do suffer severe night sweats and have done for some years, to the point where i can change my PJs or even bedsheets 2 x nightly, so wonder if this could be the case? I know I should have mentioned it to the doctor but have lived with it for so long that it's beocme "normal" to me. 

Thanks again X


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## MIKA33

Just to let you know, I have checked my prolactin results which were initially 902 and then 753 and I was referred to an endocrinologist for further investigations. I guess each hospital have their own criteria and I hope you manage to get some answers.


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## Luv one

Hello Mika,

I too suffer from high prolactin and have been on cabergoline to keep it within normal range so far it seems to be working. I had an MRI scan to diagnose this problem as it affects your fertility. Good luck!


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## jojo29

I might be too late here but I suffered with this since I was 13, I had to travel miles to see someone who even understood my symptoms back then. My levels were in their thousands, I used to have breast milk, scans showed no rumours. I Could not stand bromocroptine or pergolid so decided to try natural medicine, which was simply reducing stress levels, prolactin rises with stress and can be quite considerable, try not to get worked up, stressed at all as it triggers it to rise and interfere with ovulation, sounds primitive but will help bring levels down. 
Jojox


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