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Doctor\'s advice needed please

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greeny Group: Members  Joined: 29th Apr, 2012  Topic: 12  Post: 91  Age:  28  
Posted on:6th Jan 2013, 10:49am
 

Doctor's advice needed please

Assalam o Alaikum.  this is the problem of my very dear friend. she is desperately trying to get pregnent. but after two years of marriage unable to conceive. Her mother inlaw took her to the very esteemed gynacologist of her city.
she examined her  S. Prolactin  which was 22.8 ng/ml  she prescribed her  following medicine. tab Motilium ( domperidone 10 mg) tab Parlodel (Bromocriptine  2.5 mg)  and folic acid and calcium tabs and  citro soda sachets syp dijen.  she is taking all these medicine for two months. but no results.  she is frustrated now.  one lady health worker of her area told her that these medicine has nothing to do with her conceiving process. she needs just advice either to continue the doctor's  prescription or to consult some other doctor.  her doctor has asked her to come to visit her every month. two times she has visited her and don't want to visit her for the third time as last time doctor advised her the same medicines.  and charged her full fee. as I told you she is frustrated so she needs advice.  if any doctor could guide us. regards.
psychdoc Group: Members  Joined: 04th Mar, 2011  Topic: 11  Post: 1228  Age:  33  
Posted on:6th Jan 2013, 11:29pm
 

Greeny:


Walaikum Salam.

First of all, a serum prolactin level of 22.8 is considered normal for all practical purposes. Anything under 30 is considered normal in females ( even though some labs may consider 20 as the upper limit). It is true that elevated prolactin levels may interfere with the ability to get pregnant, and in those cases where prolactin level is high, Bromocriptine is the medication that is prescribed to bring the prolactin levels down. However, with your friend's level of 22.8, she doesn't need the bromocriptine at all. At best, I would recommend she should get a repeat prolactin level. Please also note that mild elevations of prolactin can also be caused by a variety of conditions, including stress, breast stimulation etc etc.

Her other meds are not related to infertility treatment. Motilium is prescribed for gastrointestinal problems, and calcium tabs and citro soda can be used for a variety of conditions , including supplementation, or gastrointestinal problems, or urinary problems etc etc.

If your friend has difficulty conceiving for the past 2 years, she should get her labs done on the 3rd day of her menstrual cycle, including FSH level, LH levels, TSH levels, Prolactin levels which she already had, blood glucose levels, if possible also testosterone levels, hemoglobin levels, and an ultrasound. Is your friend overweight?

She should also get her husband's semen analysis done.





psychdoc Group: Members  Joined: 04th Mar, 2011  Topic: 11  Post: 1228  Age:  33  
Posted on:6th Jan 2013, 11:56pm
 

Folic Acid:


Sorry, I forgot to mention about folic acid. Yes, I 100% agree with the decision to start her on folic acid. In fact, most women of child bearing age who can potentially become pregnant, should consider folic acid supplementation.
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