new year, renewed hope ...

Happy New Year! I am happy to put 2011 (and for that matter, the last 4 years) behind me and start fresh. I believe that 2012 will be a good year.

A lot has happened since my last post. Heather and I are both now on birth control pills, which means that our cycles can be manipulated as needed by Dr. Nash. I had my sonohysterogram a couple weeks ago, and Dr. Nash said that everything looked great.

Unfortunately, we recently encountered a big and unexpected hill on this infertility roller coaster. This time, it involved Heather. I seem to have spoken too soon in my last post regarding her lab work. As it turns out, her prolactin (a hormone produced by the pituitary gland - in the base of the brain - that stimulates breast development and milk production in women) level came back high when she had her initial blood work. This level should be low in a woman who is not pregnant or breastfeeding. Dr. Nash had her go for a redraw, just to rule out lab error. Unfortunately, the level doubled during the two weeks between blood draws. This can indicate a tumor on the pituitary gland that causes an overproduction of prolactin. Of course, we all went into high alert when we found out there was the possibility of a brain tumor. We all did way too much internet research, which more often than not results in some misinformation and worst case scenarios. I learned that these tumors (called prolactinomas) are almost always benign (not cancer), and can usually be treated with medication (more uncommonly, with surgery). I also read about some other, much more scary brain tumors and diseases that can cause elevated prolactin levels. Needless to say, we were all very worried.

Dr. Nash scheduled Heather to have an MRI of her brain, which would give us some answers. The 1.5-week span between the first elevated prolactin level and the MRI results seemed to drag on and on. Finally, on December 19th, Heather and Mom met with Dr. Nash to discuss the MRI results. NO TUMOR!!! Apparently, there are some cases in which the elevated prolactin level truly can't be explained (for my fellow medical nerds, this is called idiopathic hyperprolactinemia).

Words can't begin to describe the relief we all felt. Dr. Nash explained that he will be Heather's doctor for this issue going forward. He started her on a medication called bromocriptine, which causes the pituitary gland to produce less prolactin, thus lowering the prolactin level in the blood.

Dr. Nash assured Heather that she can still be our egg donor, and that moving forward with this process will not cause any additional issues for her. High prolactin can cause issues with infertility, so we can't move forward with this journey until Heather's prolactin level is normal. Because of potential negative side effects of the medication, Heather has been gradually increasing her bromocriptine dose. She will be at her full dose in about a week, and after she has been on the full dose for a full week, she will have her prolactin level checked. If it is normal, we can move forward. If it is still elevated, I'm guessing Dr. Nash will adjust the dose accordingly until the level is normal. Heather will have to take this medication until we are done with the egg donor process, and then she can stop taking it until/unless she starts having symptoms of high prolactin (menstrual irregularities and/or milk production when not pregnant or breastfeeding) or wants to have a baby.

I never would have imagined that a hormone called prolactin would turn our lives upside down for a few weeks! I guess the upside is that this prolactin issue was only discovered (and subsequently treated) because of Heather's generous decision to be our egg donor. :) For now, we are waiting for her prolactin get back to normal, and then we'll be full speed ahead (albeit cautiously, since we seem to have a tendency for bumps in the road) with the next step in our journey ...