What is prolactin and how does it affect IVF?

Prolactin is a hormone that originates in your pituitary gland – like FSH. It’s a multi-talented protein, performing a function in virtually every cell in your body. Most of us know that pregnant women and nursing mothers produce very high levels of prolactin. Why? Because it’s instrumental in creating breast milk.

But would-be IVF patients, and couples trying for a baby without medical intervention, need to watch their prolactin levels. It may seem like a badge of fertility to have lots of it. In fact, the reverse is true. Too much can be a barrier to conception. The good news is that it’s treatable.

A prolactin test is often recommended for women with menstrual or fertility problems. Women who breastfeed, particularly in the first few months after birth, quite often don’t menstruate or ovulate. That’s the power of prolactin: it generates milk but puts the breaks on reproduction. Mother Nature is whispering in your ear: you’ve got your hands full so don’t, for heaven’s sake, have another one yet.

Fertility-wise, Mother Nature’s postscript is that you don’t want maternal prolactin levels when you’re trying to get pregnant. A low score is desirable. A very low one will do nicely. You want to ovulate. You want a regular cycle that can be worked on by fertility treatments or drugs. You want to produce progesterone to plump up your uterine environment in readiness for an embryo or two. High levels of prolactin, called hyperprolactinemia, do the opposite of that.

Your prolactin levels vary throughout the day.  A normal starting point is 102 mIU/L. But if your reading is over 496, your conception chances may be compromised. Very high amounts of prolactin could suggest an underactive thyroid, liver or kidney problems, PCOS, stress or something else. You might even have a pituitary cyst or tumour (don’t panic: these can be treated successfully).

A prolactin test should ideally be done in the morning, and in the early days of your bleed to avoid the higher levels at ovulation distorting things. If you’re an IVF patient, it makes sense to have your other blood hormone tests – FSH, LH, TSH – at the same time as your prolactin test. You might as well schedule an AMH test, not usually required at the start of a cycle, to get it over and done with. Day two or three of your bleed is best.

Tell you doctor if you’re taking anti-depressants, anticoagulants, estrogens, the birth-control pill or any other medication. These could skew the score, as could a breast inspection, exercise or a meal rich in protein just before your blood sample is taken. Ask your doctor what you should and shouldn’t do before you go in.

One in ten women with fertility issues has elevated prolactin. If you’re one of them, all is not lost. Medication (e.g. Dostinex, the active ingredient of which is Cabergoline) is available to even out or suppress your levels, boost your fertility hopes and get you ready for a successful pregnancy – whether via IVF or not.

Source Link: http://www.yourivfjourney.com/what-is-prolactin-and-how-does-it-affect-ivf/