Prolactin and IVF

After lots of convincing, fighting, tears and endless talks, my hubby and I decided to go ahead and contact some infertility clinics for the possibility of doing IVF.

I contacted two here in the area. One of them was the New Hope Center. I heard and add in the Radio and decided to call. Before I could say much, they told me they didn’t accept my insurance and the costs reach a minimum of 10.000 excluding drugs. I was expecting high costs already, but it still hurts to hear. 

The other one I contacted and booked an appointment was The Jones Institute. I have heard many good things about them through other friends that have been in the same situation. The person that contacted me after the email I sent was very delicate and informative. They have a risk share program that if you qualify to participate, you could receive a refund in case you don’t get pregnant.

I don’t know if I would qualify, but I’d like to think I am a good candidate since nobody has really found anything wrong with me.  I did book an appointment but as usual my first visit is almost 2 months away.

Since we did not have anything to do but wait, we decided to contact two other clinics in my husband’s country back in Europe just to compare and know what all our options are. First doctor I did not like at all. For some reason I couldn’t trust what he was saying. The second clinic has been amazing though. Today the doctor sent us a two pages email explaining the whole thing after revising my medical files. What surprised me was that after explaining the IVF procedure and all the things we would have to do and when to be there, he said that my prolactin was way too high for my age. Interestingly enough I had pointed out the same to my RE here in the US right before the four IUI cycles I had last year. She actually repeated the test, but stopped looked into it since the second test was in the range (although it was in the high end). 

The doctor explained in his email that with his experience and with my files he could bet that was the problem. He also said prolactin is the hormone of stress. My husband looked at me with a smirk in his face as he translated this part of the email. I do have to agree with him, I have been very touchy and anxious about everything.  He prescribed a pill that should control the prolactin and suggested I had primrose evening oil for the next weeks. He actually said if we are not in a hurry for the IVF we should try on our own for the next 2-3 months to see if controlling this hormone would help. 

What kind of doctor will give you an option that doesn’t involve thousands of dollars? I just have a really good feeling about this one.

Progesterone 101

For the last year I have read pretty much everything available on line about infertility and endometriosis. One thing that keeps repeating in every web site is the effect of estrogen and progesterone in fertility issues. So I decided to investigate a little more. Here are some of my findings about progesterone*:

Progesterone is a steroid hormone involved in the female cycle and pregnancy. It is produced in the ovaries (by the corpus luteum), the adrenal glands and in the placenta (during pregnancy). Progesterone levels are relatively low during the preovulatory phase, rise after ovulation and are elevated during the luteal phase. If pregnancy occurs, HCG is released maintaining the corpus luteum allowing it to maintain levels of progesterone. If pregnancy does not occur, progesterone levels decreases, leading to menstruation.

Progesterone has several roles:

-          Converts the endometrium to its secretory stage to prepare the uterus for implantation.

-          During implantation and gestation, progesterone appears to decrease immune response to allow for the acceptance of the pregnancy. (I guess that’s why so many women say they get sick in the first stage of pregnancy)

-          It reduces spasm and relaxes uterine smooth muscle.

-          It acts as an antiinflammatory agent and regulates the immune response.

-          It normalizes blood clotting and vascular tone, zinc and copper levels, cell oxygen levels, and use of fat stores for energy.

Progesterone therapy is used to treat:

-          abnormal uterine bleeding associated with hormonal imbalance

-          severe PMS (premenstrual syndrome)

-          menopausal symptoms

-          induce menstrual periods (you take it during the cycle and stops right before when period is expected, almost like BC pills).

Progesterone and endometriosis

Most sources of medical information say that estrogen promotes cell growth, and that "too much" estrogen promotes "too much" cell growth. The hormone progesterone controls the actions of estrogen, therefore improving endometriosis symptoms.

Progesterone cream and infertility

Progesterone levels is pretty much one of the first hormones that doctors check when you want to check your fertility. Since it is involved in helping the uterus prepares to receive a fertilized egg.

Alternative practitioners usually recommend progesterone cream, but I read that there is no scientific prove that progesterone cream can be absorb by your body and increase progesterone levels. I would say that this is like every other alternative treatment, it might help and be good for you or it might not make a difference. Try is the only way to know it.

An advantage of using progesterone cream instead of taking progesterone orally is that it’s cheaper and it doesn’t get destroyed as it passes through the gut and the liver. 

How to use progesterone cream

You should apply the cream ONLY after ovulation, because if applied before it might prevent ovulation. If you don’t know for sure when you ovulate (my case), just start on day 16 until day 26.

The cream is best applied twice a day, to keep levels up.

Apply 1/8 to 1/4 teaspoon once or twice a day (or the dosage directed in the cream). Spread it over one area of your body such as belly, thigh, chest, face, arm, etc.). Change the place you apply everyday to avoid irritation.
Menstruation should start within a day or two of stopping the cream. 

Progesterone cream side effects
The progesterone prescription products that have been approved by the Food and Drug Administration (FDA) are safe for most people when used with the advice and care of a healthcare professional. However, progesterone can cause many side effects including stomach upset, changes in appetite, weight gain, fluid retention and swelling (edema), fatigue, acne, drowsiness or insomnia, allergic skin rashes, hives, fever, headache, depression, breast discomfort or enlargement, PMS-like syndrome, altered menstrual cycles, irregular bleeding, and other side effects.

* All the information provided are from websites such as Wikipedia, National Library of Medicine, WebMD and others. Also, I selected the information only for those who suffer of endometriosis or infertility.

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