Have I got PCOS? Prolactin/LH levels... Thyroid levels?

[Worrieddd]

Can anybody help?

Fell pregnant two years after coming off the pill last March, however had a late miscarriage. In the two years my cycles weren't the most regular, some were 47 days but mostly ranged from 32-37 days. I had two day '21' bloods done which showed I'd ovulated, doctor didn't bother with day 3 tests and DHs SA came back fine too. One thing however was that my female testosterone was slightly elevated, again the GP was not interested!

Roll on this year and we have been ttc again which seems to be taking forever...I have just turned, 31. Have had some more bloods done on day 3 of my cycle this time and:

TSH - 2.25
FSH - 6.5
LH - 7.1
Prolactin - 750 (range is 30-600)

So GP has now requested repeat blood tests based on the results. Slightly worried about the high prolactin levels and have also heard that TSH should be between 1-2 for good fertility.

Looking at other peoples levels, my LH looks quite high? However some literature states FSH and LH ratio should be 1:1 but if LH is higher it is an indication of PCOS! This coupled with the previous high female testosterone doesn't sound good does it? I've always suffered from quite bad acne on my back too. My bmi is 28 so I know I have weight to lose.

Is an ultrasound scan the only real way to determine if I have PCOS? I'm so frightened of not being able to conceive again, I feel like I've been waiting forever for a baby!

Will the GP be able to prescribe metformin for the androgens or something to bring prolactin levels down? My last 5 cycles have been pretty regular and I'm certain I'm ovulating... As my CBFM is giving me peaks and have definite temperature rise post ovulation.

Sorry this is long

[AttilaTheMeerkat]

You need a proper diagnosis of the underlying problem first and foremost.

Previous GP was ignorant and you should have had more tests done at that time to determine why testosterone was high.

More blood tests need to be done to see if either PCOS or thyroid problems are in evidence. This should all be done at a hospital subfertility unit. An internal ultrasound scan should be done to assess the state of your uterine cavity and ovaries (polycystic ovaries have what has been described as a ring of pearls appearance to them and can also be larger than a normal sized ovary. A normal sized is about the size of a walnut).

TBH I would not let the new GP mess around in potential ignorance any more and would insist on a referral to a subfertility unit. They would be the best people to see you now.

[naty1]

2 years to get pregnant is a long time.
I have pcos (no acne, no extra hair and only 9 st at 5ft4 about 22 bmi) so the list of symptoms is not all necessary. I do have irregular periods since starting, between 25-40 days.
I am also now on thyroxine for my 2nd ivf tsh had gone up to 3.7 but the clinic is aiming to keep me under 2.5
I think that the fertility monitors say they don't work for pcos
I found my gp didn't know anything the specialist at the fertility clinic was much better.
I don't know maybe you could go privately to the fertility clinic just for the confirmation of something/what is wrong maybe then your gp would have to refer you

[Cookiepants]

Hi worried, your GP may have ordered more tests to check the borderline prolactin level.

High prolactin can be caused by many things inc. stress and PCOS. In my case it was caused by a small benign tumor on my pituitary (prolactinoma). My levels were slightly higher than yours (800s) but it was enough to completely stop my cycles. It was diagnosed by MRI and I needed less than a month of treatment (tablets) to conceive my DC.

Your GP seems to be investigating things further and will hopefully be able to refer you soon. Good look baby making!

[Worrieddd]

Thanks for your replies so far.

I came off the pill and fell pregnant two years later however we didn't really 'try' every cycle and my cycle lengths are longer than 28 days so it probably took 15-18 cycles to conceive - which is still of course a heck of a long time

After my late miscarriage I had a meeting with the obs/gynae consultant who did say that I was to get referred to him as soon as id been trying for 6 months so I guess I will ask the GP to refer me at my appointment next week.

It just seems so confusing and I'm now wondering if I've always had high prolactin levels and thus being the reason it took so long to conceive, or if this is a new thing.

My repeat blood tests are just for the prolactin next week should I be asking for more? Full gynae ones?

[Worrieddd]

Well just an update if anybody is interested:

My Prolactin levels went down significantly to 278! So well within the normal range. GP thought this may be due to the 'recent' miscarriage but it appears prolactin levels can rise due to stress! Even the stress if a blood test!

The GP dismissed pcos at once saying the LH had to be atleast double the FSH for them to consider pcos. And as I have very regular cycles and have conceived naturally he wasn't concerned!

I am now actually been referred to the gynae consulatant as we have been trying for 5 cycles (6 months) post late miscarriage.