For quite a few years now, me and my then longtime partner, now husband, have been trying to conceive. We’ve seen several doctors both in the Philippines and Singapore. We’ve pretty much done whatever we could with the time (we were in a long-distance relationship) and resources that we had but everything remained unsuccessful. It was very stressful, and many times tested our relationship.

Until October 2020 came. I suddenly felt the urge to see an O&G (Obstetrics and Gynecology) doctor to do a quick check on my delayed menses. Please note that my menses have never been overly delayed. Maybe a regular one-week delay for several years now so it was not really a major concern for me then. But before my General Practitioner (GP) doctor could provide me a recommendation to a specialist, he asked me to do a comprehensive blood test first. I have been doing my blood test regularly through the years, so I felt it was routinary for me except that my GP added hormonal tests this time. The result came back, and everything was OK except my prolactin level. For non-pregnant/non-lactating woman like me, normal range of my prolactin hormone should be 4.8-23.3 ug/L only. Mine came back as 32.3 ug/L! My doctor then quickly referred me to O&G doctor.

During my visit to O&G clinic, I went for ultrasound and repeat PRL (prolactin)test. My ultrasound came back normal stating that my uterus and ovaries are normal and not polycystic. However, repeat PRL came back higher at 966.7 miu/L to which normal reading should only be </= 494miu/L! I remember receiving a call from the O&G clinic and asking me to urgently see my doctor the next day when my appointment should still be in the following week! I was so worried until I saw my O&G doctor the next day. She explained to me that my PRL tests are suggesting that I have a condition called prolactinoma. She mentioned that I may have a growth of the pituitary gland that causes an overproduction of prolactin and the only way to confirm it is via the MRI. She quickly referred me to go for MRI scan.

I’ve never done MRI before and didn’t do any research on it as all I wanted is to have my head scanned immediately and clarify what is causing the issue. I was then quite clueless on why the MRI checklist asked as to whether I am afraid of closed spaces and why the MRI nurses were very reassuring after they found out that I am claustrophobic. It’s only when I did the actual MRI that everything made sense to me! I felt like I was in a closed casket throughout the procedure! I was panicking and almost didn’t make it to do two rounds of scan (without and with contrast)!

My MRI result confirmed my condition. I have a tumor (rounded mass) demonstrated within my pituitary gland (1.4X1.2 cm size) and pressing on my optic nerves. My O&G doctor quickly referred me to an Endocrinologist.

I felt relieved that I was referred to Dr. Eric Khoo of Gleneagles Medical Centre in Singapore. I felt the need to name him on this article as he really took care of me and explained my condition very well. He explained to me that my condition is called prolactinoma which is a benign (noncancerous) tumor of the pituitary gland that produces a hormone called prolactin. High level of prolactin can trick the body that it is pregnant. He then reassured me that though my condition is affecting my fertility, it is not life threatening. He made me understand why despite the numerous attempts to conceive in the past, we ended up failing. He provided me treatment plans for my condition wherein we will do trial of medicine first and refer me to an eye specialist. I needed to see an eye specialist as my tumor is pressing against my optic nerves which explained why my vision turns blurry at times then. Luckily, all the eye tests that I did with the eye specialist confirmed that my eyesight is perfectly normal then. However, as I am going to go through medicines for my prolactinoma, there is a chance that I might conceive even on medication. When this happens, I need to stop the medication and with the pregnancy, it can naturally increase my prolactin level some more. The increase in prolactin level is proportional to the increase of the tumor which will then pose a risk on my eyesight as it is pressing on my optic nerves. There is a risk that I will lose my eyesight if it happens.

It was such a whirlwind and shocking experience to me then. I couldn’t believe that the slight delays in my menses was trying to tell me of a condition that I could have probably been having for many years now. We had been extremely stressing about not conceiving and even doing a lot of blame games which really affected our relationship in the past. If not for the additional hormonal test requested by my GP, we probably are still living in the dark. I believe that understanding my actual condition stirred my relationship with my now husband to a better stage.

Infertility is a very sensitive topic for me and for sure, it is the same for everybody who is going through the same dilemma. It could have probably destroyed relationships as it almost did with mine until we had a good understanding of this medical condition. It is for this reason that despite the sensitivity of the topic, I decided to share my experience to bring awareness since prolactinoma is not the first thing that came up as a reason when we failed to conceive before nor noted as a one of the key known reasons for infertility.

Let it be known that prolactinoma is very common. According to an article published by Oregon Health and Science University, prolactinomas are the most common type of pituitary adenoma — a noncancerous tumor on the pea-size pituitary gland. Both men and women at any age can even develop a prolactinoma, but women ages 20 to 34 are at highest risk. About one to three people in 10,000 have a prolactinoma that causes symptoms. About 5-10% of adults have a prolactinoma that causes no symptoms so many people do not know they have it unless specifically tested for.

I hope that by sharing my personal experience, I can shed some light that there are more reasons to the delay in conceiving. Most couples, like us, could have probably spent a lot of money in the past trying to confirm their ability to conceive and upon confirmation, been trying to explore expensive medical means to conceive yet miserably failed. If you are one of those people, please ensure that you get your prolactin level tested next time you go for a blood test. It might shed some light to your current situation just like how it did with mine.