Question:
Hiya,
I'm 28 years old and had the first cycle of ICSI done a month ago. The reason for ICSI was that my husband has a very low sperm count and motility. My test date was 26th August and I started bleeding on the 24th of Aug. I went for a beta hcg which was 4.73.
I had a high prolactin level (35) for which I was given Dopergin (Bromocriptine) until Embryo transfer which was on the 12th of Aug. I was not told to continue it and I was stupid enough not to ask about it. I had 3 Grade A embroys transferred but there was no implantation. I had my prolactin test done on the 25th of Aug and it was 48.
My question is, could the high prolactin have been a reason for implantation failure? I'm not trying to play a blaming game but I need to know if this could've been avoided particulary as have nine day 2 frozen embryos and I plan on going for FET after my next cycle in September.
Thank you. A. from Spain
Answer:
Hello A. from Spain,
It is our protocol in the U.S. to check all the hormones prior to starting any infertility treatment cycle. This is so that we can eliminate anything that might interfere with the success of the IVF cycle. Of course, we check other things as well, and thus, have the highest pregnancy rates in the world. Traditionally, prolactin levels were measured in ng/ml, and normal prolactin levels in women are less than 20 ng/ml. (The new units now are pmol/l and to convert you need to multiply by 44. This means a normal level is less than 700 pmol/l.)
Since your prolactin was found to be elevated prior to the IVF cycle, and 35 is not very elevated, you were been placed on the Bromocriptine ahead of time in order to get the level back to normal prior to starting the cycle. There is no question that an elevated prolactin level can interfere with fertility.
My recommendation would be to get your level back to normal prior to your FET cycle!
Sincerely,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.
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