QuestionQUESTION: I am 28 year old female with hyperthyroid currently in remission-but always under control usually on PTU for 50 mg twice a day. Regardless, I have a healthy 3 year old son born in 2008. In Dec. 2009 I had a miscarriage early in the pregnancy no DNC was required. In Jan 2011 I again had another miscarriage early in the pregnancy again. My last date of period was dec. 19 so on JAN 20 my hcg was 6 -which made no sense and then on the jan 25th my hcg was 14. On Jan 28th I miscarried again no DNC required. My question is-assuming my thyroid is under control and because I never had a DNC can i try to conceive right away or do I really have to wait?-Also are there any tests you suggest I should get my gynocologist to perform. Another odd thing is that I still lactate if i express myself every since I've had my son, i've had a blood test for prolactin twice which came back normal-do you know what might be contributing to these miscarriages?
ANSWER: Dear Mobina
It is not necessarily for prolactin to be elevated in order to have lactate after expressing your breast. In some women, breast becomes supersensitive to noral levels of prolactin. This would definitely affect the function of corpus luteum which is responsible to maintain growth of pregnancy up to 12 weeks. This supersensitivity may interfere with the corpus luteum function. This is one possibility but other possibilities do exist for recurrent miscarriage. Some forms of treatment that lower prolactin level are useful to decrease the supersensitivity and can be tried but this should be under medical supervision.
Therefore you may consult a reproductive endocrinologist in Canada where you live.
Good Luck
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QUESTION: Thank you for your reply. I have recently seen my endocrinologist soon after your response. So my thyroid levels were fine during my miscariage. I was hoping you could elaborate more on what you were trying to explain to me regarding the corpus luteam. If you could tell what exactly I might say to my family doctor so he can refer me to the appropriate specialist. My endo. doesn't know what to do about the lactating. If you could explain more throughly what exactly you mean maybe I can further explain it tothem as well.once again thank you for your help.
AnswerDear Mobina
In simple words, since your breast expresses milk on squeezing, my advice is to take one of the drugs that lower prolctin level such as bromocryptine or dopergine or similar drugs, although you have normal prolactin level. The expression can be related to enhanced sensitivity of your breast rather than elevated prolactin level. This kind of drugs are also helpful in decreasing sensitivity.
This would help your breast to stop expression. In many ocassions, once your breast is dry, you can try to conceive. Such empirical therapy proved effective in many ocassions.
Good Luck
