Cause of Infertility: High Prolactin, Low Progesterone

Before I got married, I had myself checked if I am capable to "spawn".  Initial diagnosis was very positive. I do not have a defective hardware: no odd cysts, correctly shaped uterus, on time ovulation with healthy eggs.

I was also very much in tune with my reproductive health and I have been doing regular pap smears since I was 28.

Apart from my regular check ups, I also know how to do calendar method and monitor ovulation through my cervical mucus.

If you are wondering why I know so much about reproductive health, that's because I am a hypochondriac (from my OCD) and I have a interest in biology and pharmacology.

That being said,  I got married with full confidence that conception would not be an issue.

When I got married in 2014, I purposely didn't try to have a baby. That means I avoided all my fertile days and I only had intercourse during my safe period. I planned not to conceive for a year. I actually thought that one unprotected contact would instantly make me pregnant.

Then on New Year's eve, it occurred to me that I would be 33 and I panicked. On that very night I had unprotected contact with my husband.

Nothing.

We tried again the following month and then the next.

Still Nothing.
 

By May, I was certain that something was wrong so I went to the specialist. By the time I went to see my doctor, I have already done charting for 6 cycles. My husband had completed his sperm test and was normal. I was suspecting I had infertility.

Infertility is not being able to get pregnant after one year of unprotected sex. It is strongly advised that women who do not have regular menstrual cycles, or are older than 35 years and have not conceived during a 6-month period of trying should see a doctor.

In most cases of infertility, it is usually the woman who needs to be checked thoroughly. That's because our body is a freaking wonderland. Regardless how low the sperm count is, you only need one to conceive. On average a man releases 40 million minumum per ejaculation. The ideal is 200 million above.

Here are some of the common reasons for infertility in women:

1. Failure to ovulate or weak eggs
2. Endometriosis
3. Blocked Fallopian Tube
4. Polycystic Ovaries

FYI: You don't tested for everything all at once. Please be prepared to spend at least 6 months.

The doctor will do intravaginal ultrasound to do  your pelvic exam. She will be able to see if you have Polycystic Ovaries and if she "should" suspect Endometriosis. She will still require a blood test and maybe even a Laparoscopy to asses the if the Endometriosis is mild or severe. The check for the Fallopian tube is called Hysterosalpingogram and is also very intrusive, so they don't do it right away.

Since the doctor saw that I ovulated and based on my charting I had regular periods, the next step was to do blood tests.

All my numbers were within the normal range except for my PROLACTIN is which 300% higher than the reference. The limit was 26 and I was at 80.

Ding ding ding!

Prolactin is a hormone that helps make breast milk. That is why women don't easily get pregnant while they are breastfeeding. It is released by the pituitary gland, which located in the brain.

Severe cases of hyperprolactinemia (high prolactin) can stop periods and even cause non-pregnant women (or even men)to lactate! At it worst, it can affect vision.

The causes of Hyperprolactinemia are:
1. A benign brain tumor in the pituuitary gland that produces high levels of prolactin,
2. Over active cells in the pituitary gland
3. Underactive thyroid
4. Medications for depressions
5. Stress

When I saw that brain tumor is one of the causes, I seriously feared for my life. I was adamant that I did not want to go through MRI. God knows what they would find there. I didn't want to go looking for stuff.

I feared that the tumor would grow big and hit my optic nerve and I would lose my eyesight.

My cousin, one of the best ophthalmologist in our region, assured me that deterioration of vision caused by Prolactinoma (bening tumor of the pituitary gland that produces a hormone called prolactin) is reversible.  It can be removed by gamma rays and eye sight will return to normal.

But still I was scared even if I knew that it could be addressed through medication, surgery or radiation,

So, started my period of depression. I spent many days in my dark room sleeping.

At that point, I just didn't care about having a child. My survival instincts kicked in and I just wanted to live.

The doctor assured me that there is no need to do MRI because my numbers were not above 500 but still, I knew that one could never be too sure unless one agrees to do CTSCAN or MRI.

The only thing that comforted me was the  fact that if I did have a tumor, the first line of cure would still medicines: either Bromocriptine or Carbelogine. They won't jump to surgery or radiation anyway. It's the same initial treatment for both a tumor and a hypergland.

Because I still have regular periods and ovulation, I technically had the mild case of Hyperprolactinemia.

As a result of that I have a short luteal phase.  That explained by I only had a 23-26 day cycle.

Short Luteal Phase means I have less days to allow progesterone build up. After  ovulation, my progesterone level was only at 3. A woman needs 10-15 to sustain a pregnancy. The lack of progesterone is necessary for the endometrium lining the uterus. The endometrium lining needs to be in perfect condition and thickness for sustaining a healthy pregnancy. 
 

For a couple of months I was on Bromocriptine (Parlodel) and Progesterone (Duphaston). On top of that I also had to take Metformin for my sugar and Euthryrox for my thryroid. 

I had a cocktails of pills, which made me depressed because I really felt that I was disturbing the balance of my body.  I told my husband that maybe I wasn't meant to get pregnant that's why God put the problem in my brain. It was literally in my head! 

I was so pissed when people asked me if we are already pregnant. 

I wonder why some people just casually ask, "O, Meron na?" which is translated to "Are you guys expecting?" For one thing, can't you see how flat my tummy is? I work out for that by the way. Or when they ask, "O, wala pa?" which is  translated to "Nothing yet"? Well forgive us for not trying right away. We actually just enjoyed sex right after marriage with no objective to conceive.

I also hated it when people gave me chores/duties. "Can you be here on this day?" , "Can you get me this?" , "Can you do this?" I was really worried about the possibility that I had a tumor in my head. Do you really think I care about your life?

I was in a very bad place.

Then I gave up trying and just took all my meds and prayed. 2 months of all the meds and blood tests, felt like an eternity. 

After 2 months, apparently I conceived. I found out when I missed my period of the 3rd month.

Now you know! I am now very pregnant and I can already feel the fetus moving.

Thankful,

L