How Does Prolactin Affect Fertility & Egg Freezing?

When should I test my prolactin levels?

Prolactin isn’t a routine hormone that’s tested to check your ovarian reserve. But you may be recommended a prolactin test within a full hormone panel or if you show symptoms of higher than normal levels. 

For instance, it may be part of a routine hormonal profile if you have abnormal or irregular periods. 

Testing for prolactin levels is a simple blood test. Your healthcare provider will take a blood sample from a vein in your arm, and collect it in a test tube. 

But the test itself might need some preparation beforehand. Here's everything you need to know:

Timing and Preparation:

• As prolactin levels fluctuate throughout the day, early morning testing is preferred for more accuracy (2-3 hours after waking)
• You may be recommended to fast for 8-12 hours before the test
• It’s recommended to schedule your test during the first week of your menstrual cycle if you're having regular periods
• Avoid testing right after a physical exam or breast examination as any stimulation to the nipples can increase prolactin levels
• Avoid physical or emotional stress before testing and get adequate sleep the night before (lack of sleep can increase prolactin)
• Some medications might affect your test results. Be sure to let your doctor know beforehand.

Prolactin Normal Ranges for Women

Normal prolactin levels for non-pregnant women/females assigned at birth range from 13-25 ng/mL or  40-520 mIU/L. 

But naturally, prolactin levels tend to increase during pregnancy, as the glands double in size. In fact during pregnancy, levels can rise up to 200-300 ng/mL.

What causes high prolactin levels?

👩‍⚖️Here's the deal: High prolactin levels don’t have a single cause, but are rather due to natural reasons or medical conditions.

High prolactin levels or hyperprolactinemia is found in up to 10% of the population and 5% of patients who present with infertility.

Now, stats aside, let’s dive into the exact reasons that might cause high levels of prolactin:

Natural Life Events

• Pregnancy: Your body naturally increases prolactin to prepare for breastfeeding
• Breastfeeding: Prolactin works overtime to ensure healthy milk production for your baby
• Stress: Those tough days at work? Your body might respond by pumping out extra prolactin
• Exercise: Intense workouts can temporarily boost your prolactin levels
• Sleep Changes: Even disrupted sleep patterns can throw your prolactin into high gear

Medical Conditions

• Prolactinomas: These small, usually benign pituitary tumours can be prolactin-producing troublemakers
• Thyroid Issues: When you have low thyroid hormones, it leads to your prolactin release speeding up 
• PCOS: This common hormonal disorder can lead to an increase in your prolactin levels 
• Kidney Disease: When kidneys aren't filtering properly, prolactin can build up in your system

Medication Effects

• Antidepressants: Some antidepressants might play a partial role in raising prolactin levels
• Blood Pressure Meds: Certain medications such as verapamil controlling your blood pressure could raise prolactin levels
• Acid Reflux Medicines: That heartburn relief might come with a side of elevated prolactin

What causes Low Prolactin Levels?

While higher prolactin levels are commonly seen, there are some cases of low prolactin levels as well, which can be caused by:

• Pituitary Problems: Damage or disorders of the pituitary gland, which directly affect its ability to produce prolactin caused due to injury, surgery, or Sheehan's syndrome.
• Medications: Certain drugs, especially dopamine agonists, can suppress prolactin production as a direct effect or side effect.
• Autoimmune Conditions: The body's immune system may attack the pituitary gland, reducing its ability to produce hormones including prolactin.
• Severe Health Issues: Major systemic conditions like kidney disease, liver failure, or severe malnutrition can disrupt normal hormone production.
• Genetic Factors: Some people inherit genes that affect their ability to produce normal levels of prolactin.

Prolactin and Egg Freezing: What's the Connection? 

The relationship between prolactin and egg freezing starts with routine investigations before any egg-freezing cycle.

Prolactin is often recommended as a routine test along with FSH (follicle-stimulating hormone) and LH (Leutinizing hormone) before considering egg freezing.

Here's a look at why prolactin levels matter when you're considering egg freezing:

• Prolactin levels can affect how well you respond to fertility medications
• In case of high prolactin levels, you may be recommended medication such as bromocriptine or cabergoline to reduce prolactin levels
• Prolactin levels tend to increase during the stimulation process. In fact, studies mention that prolactin levels of >16.05 ng/mL saw better number and quality of oocytes
• This indicates a relationship between prolactin levels and egg maturation. Ultimately, prolactin could influence how your ovaries respond to stimulation, promote the development of follicles, impact the maturation of eggs and even help embryonic development.

The key takeaway? If you're considering egg freezing, checking your prolactin early on in the process can help. Knowing your prolactin levels and managing them before and during egg freezing can significantly impact your success rates. 

Affordable Prolactin Testing in the UK, via Amilis

About 751,000 women are waiting for gynaecological care in the UK, of which 30,000 women have been waiting more than a year for an appointment.

Be it egg freezing, getting a hormone panel done, or even an ultrasound appointment.

So at Amilis, we decided: This narrative, no more.

That’s why we are working to make reproductive care accessible and affordable in the UK.

Here’s how:

• Get your prolactin tested via a full hormone panel test via Randox with minimal to no wait times, and at discounted prices. Get tested at a nearby Randox clinic, at your schedule.
• A personalised, free hormone panel report 
• Free consultations with top fertility clinics and doctors, at your convenience
• Match with fertility specialists and expert doctors with no waiting times

And throughout, you’ll have Amilis experts supporting you on your journey.

Figuring out where to get started? Book a free call, or take our personalised fertility quiz to know more!

We’re bridging the healthcare gap for millions of women in the UK, one day at a time 💪🏻

Frequently asked questions

Does high prolactin affect egg retrieval?

High prolactin levels can affect egg retrieval and fertility. When prolactin is elevated, it disrupts the hormonal balance involved in the menstrual cycle. During egg retrieval, high prolactin can interfere with ovarian stimulation protocols, potentially reducing the quantity and quality of eggs collected.

Can high prolactin cause infertility?

Hyperprolactinemia can cause infertility by suppressing gonadotropin-releasing hormone, which in turn affects the release of FSH and LH. This hormonal imbalance can lead to irregular menstrual cycles and even anovulatory cycles, where eggs are not released during their menstrual cycle.

Can you still ovulate with high prolactin?

Ovulation becomes difficult but not impossible with high prolactin levels. Some women may still experience ovulation, though it is often irregular and less predictable. The hormonal disruption can make conceiving naturally a bit more challenging.

Can I get pregnant with high prolactin?

Pregnancy is possible with high prolactin, but it often requires medical intervention. Fertility specialists can help by treating the underlying cause of elevated prolactin, prescribing medication to lower hormone levels, and providing targeted hormone therapy or treatments such as IVF.