What is prolactin and how does it affect IVF?

28 Aug What is prolactin and how does it affect IVF?

Prolactin is a hormone that originates in your pituitary gland. It functions in virtually every cell in your body. Pregnant women and nursing mothers produce high levels of prolactin. Why? Because it’s instrumental in creating breast milk.

IVF patients, and couples trying for a baby naturally, need to watch their prolactin levels. It may seem like a badge of fertility to have lots of it. But the reverse is true. Too much prolactin is a barrier to conception and successful IVF treatment. The good news? It can be fixed.

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

You don’t want maternal prolactin levels when you’re trying to get pregnant or having IVF. You want to ovulate. You want, ideally, a regular cycle that can be controlled by IVF medication. You want to produce progesterone to plump up your uterine lining. High levels of prolactin, called hyperprolactinemia, can stop that happening.

A normal starting point for prolactin is 102 mIU/L. If your score is over 496, your conception chances could be compromised. Very high levels could mean an under-active thyroid, liver or kidney problems, PCOS or stress. You might even have a pituitary cyst or tumour (don’t panic: this is unlikely and can be treated successfully).

A prolactin test should ideally be done in the morning. It can be done on any day of your cycle. For IVF patients, it makes sense to have the other blood-hormone tests (AMH, FSH, LH and TSH) at the same time. But if you do them all together, they must be done on day 2 or 3 of your cycle.

Normal prolactin levels, in a 2018 study of ICSI and prolactin, could lead to better-quality embryos in an IVF cycle. Tell your doctor if you’re taking anti-depressants, anticoagulants, estrogens, the birth-control pill or any other medication. These could skew the prolactin result.

1 in 10 women with fertility issues has elevated prolactin. If you’re one of them, all is not lost. Medication (e.g. Dostinex) can balance your prolactin levels and boost your pregnancy chances – whether via IVF or not.