I am in my 30s and I have PCOS and a high prolactin level. Can I get pregnant?

Patient's Query

Hello doctor,

I am a 31-year-old female. I have PCOS, high prolactin level, my TSH is 4.26 for which I am taking medicine and for prolactin and my AMH is 17. I got pregnant with twins when I was taking 100 mg of Clomid but there was no heartbeat by week 10. I had a few miscarriages two years ago and I only got pregnant because I was taking Clomid. I cannot get pregnant on my own because I am not ovulating. The next step is either IVF or IUI. Also, when I had my miscarriages two years ago, the doctors never checked my TSH and prolactin levels. So, I think that was the reason for my miscarriage but they did a lot of blood work for everything else and said everything was normal. I am on Cabergoline 0.5 mg and Levothyroxine 0.05 mg. I am taking a medicine for prolactin too. So my issues are high TSH and prolactin and PCOS. I get my periods every two months usually. My AMH is 17 ng/mL, prolactin is 47.23, rubella IgG at 394 IU/mL, free T4 at 1.39 ng/dL, TSH at 4.26, glucose 88 mg/dL, varicella zoster IgG 3.94, homocysteine 7.2 umol/L, and insulin at 9.6. Are there any chances of me getting pregnant?

Answered by Dr. R Balakrishnan Menon

Hello,

Welcome to icliniq.com.

I do not see any reason for you to worry or panic.

I feel you will not only conceive but also have a healthy baby soon. Let me explain it why I feel so one by one.

Nowadays, ladies think of having a baby after the age of 30s. Of course, the age above 35 years is considered a risk factor as the quality of eggs left after 35 years is poor. The age of the oldest mother is 45 years. Many females conceive in their 30s. So, the age factor is ruled out.

History of miscarriages - Had you not had any pregnancies till date? In your case, the prognosis is bad. As you have had a pregnancy, you can still surely get pregnant.

AMH (Anti-Mullerian hormone) and PCOS (polycystic ovary syndrome) levels only show that your ovaries have lots of eggs. They just improve your pregnancy chances and it is due to this, you had a huge number of eggs that lead to a twin pregnancy.
As your AMH is very high, you will need not only induction of follicles, but also hormonal inductions with hMG (human menopausal gonadotropin) injections will improve the endometrial receptivity and better support the implantation.
The miscarriages can be due to genetic problems in the baby, but the absence of fetal heartbeat can be due to lack of initial support and poor decidual reaction. So, a better hormonal preparation will be helpful.
Prolactin and thyroid at such a low level will not cause miscarriage. They are above the upper limit. Also, levels higher than this will not affect the baby. They may prevent ovulation on time.

Remaining are the tests of rubella and varicella etc. They can be forgotten as of now as they point out to only some minor infections. They will not affect the baby.

So, if you are having a good ovulation induction with Clomid (Clomifene) and hMG, I suggest you go ahead with the IUI (intrauterine insemination). You will surely get pregnant. But, do not forget to have a good luteal phase with progesterone support. This will improve the implantation. Consult your specialist doctor, discuss with him or her and take the above medicines with their consent.

You also need a lot of positive thoughts, hormonal help and you will surely do great.

Hope I have clarified your query.

For more information consult an infertility specialist online --> https://www.icliniq.com/ask-a-doctor-online/infertility-specialist

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