German fertility specialists implement the newest techniques, helping to estimate prolactin level with maximum precision and to treat hyperprolactinemia in men and women within a short therapy course. A team of fertility experts at German clinics usually includes experienced endocrinologists and neurosurgeons, who successfully manage the prolactin ratio with newest types of medication. The international patients can in some cases consult a German specialist per Skype or telephone. It allows providing more information about the further diagnosis and treatment of higher prolactin level at German clinics.
Prolactin is a hormone, produced with a pituitary gland, which can have a significant effect on fertility. Higher level of prolactin (hyperprolactinemia) in women is a hidden cause of recurrent miscarriages (usually in the 8th or 10th week) in women and the whole scope of frustrating symptoms in men: lower libido, weight gain, erectile dysfunction etc. The conditions, which may underlie these troubling symptoms both in men and women, are the following:
- Prolactinoma (tumor of a pituitary gland)
- Cushing disease (excess growth of pituitary gland)
- Adrenal insufficiency
These conditions block fertility both in men and women. Only after special therapy can healthy pregnancy be achieved. Abnormal, pathological increase in prolactin (Hyperprolactinemia) may be caused with pituitary tumor (prolactinoma) and some other diseases of the brain. Lower estrogen, lack of thyroid hormone and chronic renal failure may also trigger prolactin production. Certain medicines can cause elevation of this hormone in blood, resulting in hyperprolactinemia:
- antidepressants (selective serotonin reuptake inhibitors)
- antiemetic preparates (metoclopramide, domperidone)
- calcium channel blocker (verapamil)
- hormone contraceptives for women etc.
Higher prolactin level is observed in every fifth woman, struggling with infertility. Hyperprolactinemia may result in:
- disruption of the menstrual cycle
- higher breast secretion
- higher risk of miscarriages due to higher prolactin
Pituitary hormone excess (hyperprolactinemia) in women disrupts the synthesis of other hormones that regulate the cycle. Women with such symptoms are considered to be infertile.
The general diagnostics at German clinics includes determining the level of prolactin and other hormones in the blood plasma. Too much prolactin in women may be a symptom of severe physiological disorders. For this reason it is also advisable to perform the following functional tests:
- Craniogram (X-scan to exclude pituitary tumor)
- X-ray computed tomography or nuclear magnetic resonance (NMR) imaging of the head;
- Research of fundus and visual fields
If the results of bloodwork have shown the elevated prolactin level (hyperprolactinemia), it is necessary to repeat the analysis in order to exclude errors. Blood samples for the analysis of prolactin level should be carried out from 9 to 12 o'clock in the morning on an empty stomach.
Specific levels of prolactin in a blood test help to specify the cause of hyperprolactinemia: the level in excess of 200 ng / ml (4000 IU/L) usually reports on pituitary macroadenoma; the level lower than 200 ng / ml (4000 IU/L) implies the pituitary microadenoma or idiopathic hyperprolactinemia.
In addition to determining the prolactin level, it is an imperative to check the function of the thyrоid gland, as well as to check the level of other hormones. The cost of detailed blood diagnostics in Germany makes up about 500-800euro.
Currently German clinicians use both medications and surgical methods for the treatment of hyperprolactinemia. At the stage of preparing for pregnancy (including IVF cycles) you will be offered to take modern medicines which inhibit the production of prolactin. Treatment with these drugs continues until pregnancy.
German specialists prescribe combination of medicines, which should be taken in cycles of 6-24 months. As the prolactin level comes to norm, menses and ovulation get restored (in 80% of cases). In 70% of all treatment cases women achieve the awaited pregnancy after one or two cycles of medicines to treat hyperprolactinemia.
Even if the high prolactin level is induced with the pituitary tumor, surgery is required only in very few cases. Usually the tumors are managed with medicines of a new generation (i.e. N-progesterone inhibitors). If surgery is still indicated, it is performed with minimally invasive techniques through the nasal cavity, without skin incisions. Radiation therapy is implemented in case of the aggressive growth of prolactinomas.
Our experience shows that very few infertile men and women are aware of new methods of infertility treatment in Germany. We would be glad to consult you on modern techniques of treatment and find the most competent specialist for you, who will detect the fertility problem and eliminate it.