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Infertility

Prolactin

05/14/2008

Question:

Please i`m married for a year+ but no baby yet. I got married as a virgin. Do i need HSG test?i`ve not been able to do it as i have discharge and they said every where has to be dry befor it is done . hormonal tests indicate there is hyperprolactinemia.Is it not the likely cause? Should my doctor start treament instead of waiting for HSG?

Answer:

The routine work-up for infertility would begin with a semen analysis in your husband to evaluate his sperm counts.  If you are having regular menstrual cycles, a blood test can be drawn to determine whether or nor you or ovulating.  Finally, an HSG would be performed to determine if your fallopian tubes are open.  The presence of vaginal discharge in the absence of infection should not prevent you from having an HSG, as we clean your cervix (opening to the uterus) with betadine prior to the procedure.   

With regards to your hyperprolactinemia, it should be repeated when you are fasting (usually, first thing in the morning before you eat).  If it still elevated, we recommend imaging (MRI) of the pituitary to rule out the presence of a tumor that secretes prolactin.  If this is normal, and you have irregular periods, treatment of the prolactin can be attempted (normalization of prolactin levels can restore your periods to normal).  If your periods are normal, and your MRI is normal, we would recommend fertility treatment.  For more information about fertility treatment options, you should discuss this with your physician. 

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Response by:

Daniel B Williams, MD Daniel B Williams, MD
Formerly:
College of Medicine
University of Cincinnati