High stress job - impact on hormones, ttc?

[wonderingwonderingwondering]

Myself and my partner have been TTC close to one year now, 38f 39m.

Went through some fertility investigations in recent months, which revealed my AMH of 10, AFC 11, and a polyp in a scan that I got removed via hysterocopy a few months ago. Partner in early stages of semen analysis, there may be issues we need to deal with there too.

In routine bloods post surgery my gynae came back with news that I have very high prolactin levels - 600. She's sent me for MRI to determine if there's anything on my pituitary gland, and also referral to endocrinologist for further investigation.

I've been reading up about it a lot, and can see that it's something that is 'easily fixed" via medication, but also that stress can have a major impact on levels.

This rings true for me, since about a year ago i got promoted into a senior position within my sales department in a very busy, hypergrowth start-up. The job is, in a word, chaos and I've found myself struggling to manage the demands of it, and waking up with fear and dread every morning. There's also a bit of travel involved, long hours, early morning flights etc.

I've at the stage where I just want to do what I need to do to conceive above all else. Financially, we're in an OK spot and could probably survive if I quit this job and spent some time seeking something more balanced.

But I also don't want to jump the gun and throw my career out the window.

Does anyone TTC have experience of high stress impacting hormones and fertility?

If it helps I think prolactin levels can fluctuate a lot. I did a Hertility at home blood test and my prolactin came back super high (like 1800) and so they offered me a free repeat which I did again and was still really high (1600). Went to the doctors a couple of weeks later and they repeated the test again and it had gone back to normal levels. We were trying to sell our house at the time which was quite stressful so it may have been that. Anyway I think it’s definitely good to rule out a pituitary tumour just in case (apparently they are very easily treatable with medication). I can’t say whether your job is affecting your ability to conceive, but I agree with @idealgift that if you are waking up every morning filled with fear dread that sounds really shit - life is too short to deal that way everyday over a job! - and so I would probably suggest moving anyway…

My partner has a higher salary and his job is definitely more stable. I have a very decent salary too. I work for a start-up, which means the same security isn't there. Albeit my team has had a good year, so there's temporary safety and career momentum. That has come at a big cost to me though, time-wise, mental health wise and potentially physical health wise.

The high prolactin has made me think about physical symptoms - I've been feeling lethargic, struggling with executive function and migraines for months now, so it tracks.

I'm pretty clear about the job: it is not viable long-term, if my future includes kids, and I feel if I had a clear mind and a moment to pause and reflect, a career change would be afoot.

I just don't know how to handle that in the NOW - where pressures are huge, we are TTC, house-hunting, and I can't seem to find the time or the energy to focus on a new job / career hunt. The biggest impact is what this is doing to my body, my fertility hormones, and my ability to conceive.

I think I would wait and see if they can find what is causing the high prolactin. If it’s a pituitary gland tumour, then it has nothing to do with your job. If it’s not, but your prolactin is still high, then that’s probably your body trying to tell you something, ie take it easier!

NHS gave me bromocriptine to manage my prolactin levels during my first transfer. It implanted but unsuccessful. I’m with Create fertility now and have had 2 failed transfers. I asked them to look into my prolactin prior to my second transfer and the doctor was very dismissive about it.. some clinics look into it and some don’t and I cannot understand why. He also said anything under 1000 is acceptable and does not affect anything.. I would want to have my prolactin level managed again before my next transfer - why not.

@wonderingwonderingwondering I have high prolactin but I do have a microprolactinoma. Stress can indeed cause high prolactin. One of my tests was to be hooked up with a cannula for a few hours to ensure I was calm to take several blood samples so they could even rule out the stress of having a blood test raising my levels!

@4thcyclelucky I'd seek a second opinion on that, my endocrinologist wants mine under 400 and ideally closer to 200 for successful implantation. I have had a successful (IVF) pregnancy in the past while medicated but I think my levels were around 400 at the time.

Hi @Granolabox that’s really interesting - when I had my prolactin levels retested for the second time my levels were 494 but they said anything under 600 was fine. I feel like with all these blood tests different doctors seem to have different parameters for what is normal and what is optimal - it’s so confusing!

@Goldendoodlelover I agree, I've actually been under the care of several different endocrinologists/registrars for this condition over the last few years (as well as IVF consultants) but this is the first one that has mentioned this. I trust him though as he has been the most thorough!

Thanks all for your feedback. I think I'm going to wait until I meet the endocrinologist and can get to the root of the issue. My gynae really freaked me out about it, but on googling, it looks like a level above 1000 is typically where a benign tumour might be at play and prolactin levels seem to be really sensitive and prone to fluctuating. I did get tested in the morning as I was rushing to work so that might've had an impact.