Sunday, March 3, 2013

The reason for repeated failed coneption might be increased prolactin production

Prolactin is a hormone that control many chemical processes in body. The most important and key process is the lactation initiation. Another not less important is during the strong mother – child bond creation which failure can cause possible mother absence for a little child. 
In normal life prolactin doesn’t play such an important role. It production is major during night time mainly in REM sleep stage. During daytime it is mainly used during the psychical balance disturbance and coming stress situation. It means that its main purpose is to get the organism ready to cope with an upcoming stress situation. The place of its origin is the hypophysis in brain.
Hyperprolactemy – it is an increased prolactin level contained in blood. This increased production mostly causes menstrual cycle disturbances where usually goes completely away. This is caused by the prolactin’s effect that blocks eggs grow process (This is a main cause in the 10% of the cases).
Precautions in hyperprolactemy
If the woman fails to conceive it is necessary to perform some examinations before the treatment process itself. These examinations include blood tests. Blood test for the prolactin level should be performed during morning time approximately 2 hours after the wake up when the physiological prolactin level is still low and does not distort results. If the high prolactin level is confirmed the treatment follows. The treatment is usually in form of pills that lower the prolactin level.
For some women it is possible to determine clear cause of the trouble. This cause is usually non-benign cancer of the hypophysis in brain. If the tumor is smaller than 10cm (3.9inch) it is the microprolactinom. Tumor bigger than 10mm (3.9inch) is called macroprolactinom. In this case the pharmacological treatment is used as well. This treatment not only leads to lowering the level of created prolactin but also the total amount of prolactin in the body. In more rare cases, where the pharmacological treatment is not successful is possible to use radiotherapy using Laksell´s gamma knife.
How to recognize higher production of prolactin? (Hyperprolactemy)
·         Menstrual disorders (total disappearance of menstrual cycle)
·         Problems in conceiving
·         Sensitivity and pain in the breast area
·         Secretion from one or both breast
How to recognize lower production of prolactin? (Hypoprolactemy)
·         Usually not even recognized
·         Troubles with the beginning of lactation (or no lactation at all)

Because prolactin is a stress hormone, it is true that the more woman is stressed out the more prolactin level increases and with longer periods of these episodes the issue can become chronic. That’s why the best prevention for the infertility caused by any reason is the calm and well balanced environment.
Another reason for infertility might be endometriosis
Endometriosis is the common reason for the women infertility. It is a chronic disease characteristic for its endometrium outside of the vaginal area. It is quite a common disease that affects approximately 5-10% of women population in reproductive age. Up to 70% is recidivist.
Endometriosis symptoms:
·         Irregular painful menstruation
·         Pain during sexual intercourse (can lead to its refusal)
·         Chronic pain of stomach
·         Fertility issues
Endometriosis and infertility
One of the complications of endometriosis is the lowered throughput of fallopian tubes and lower production of ovulocytes in ovaries that can lead to the total infertility. Endometriosis occurs in 7-10% of women in their reproductive age.  Incidence for women that are already treated for infertility is 6-8 times higher.
Endometriosis treatment
Endometriosis is hormonally dependent illness and so the primary treatment should always be hormonal. If needed the solution is always to undergo a surgical treatment or use analgesics treatment that should be just a supplementary treatment for hormonal treatment.  
Main target for the hormonal treatment is to temporarily cancel menstruation and thanks to that suppress the endometrium growth outside of the vaginal area. This will lower and eventually kill the core cells of the endometrium outside of the vaginal area. If this procedure is successful the woman health state will rapidly improve.
At present day there is no way to completely cure endometriosis. According to recent statement of American Society for Reproductive Medicine endometriosis should be assessed as chronic illness, requiring all life therapeutical plans having in mind maximum use of pharmacological means and limited repetition of surgical procedures.
The most common reasons for infertility:
·         Disturbances in menstrual cycles, with amenorrhea – when woman will stop menstruating in the time of her menstrual cycle
·         Syndrome of polycystic ovaries – excessed number of little follicles is produces in ovaries, that are not able to fully grow thanks to the hormonal misbalance
·         Hyperandrogenal syndrome – increased level of man hormone
·         Post pill amenorrhea – long time use of hormonal protection that can lead to the loss of menstruation
·         Women that are extremely thin or with excessive overweight or physical load (professional sportswomen)
Ovarian function failure
Ovarian failure is an ovarian function failure for women before their forties.
The lowered function of the ovaries tissue can be caused by the repeated ovarian operation (when removing cysts from ovaries endometriosis)
Morphologically conditioned infertility
This type of infertility is usually connected with the lowered throughput of the fallopian tubes. These are usually caused by gynecological inflammations (adnextidis), after repeated stomach operations and also for other than gynecological reasons (for example Crohn disease). Morphologically conditioned infertility can start from endometriosis.
Congenital infertility
Is usually caused by Turner´ syndrome, where the woman is missing one genital chromosome X, which causes that ovaries are not fully evolved and can´t fulfill their natural function.
Immunological infertility
Immune system of some women creates antibodies against the man´s sperm or against own ovaries. These antibodies are the main reason for infertility.
Drugs effect
Problems with conception can be also caused by some drugs. For example “The syndrome of uncracked follicle” where the egg is not released from the mature follicle. This might be caused by some painkillers (inhibitors of prostaglandin synthesis).

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