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CAN SHE CONCEIVE NATURALLY?
Hello Doctor,
My partner is 42 years old (female) . We want to try for pregnancy right away. Her menstrual cycles are regular every month.
We recently did a pre-conception blood and urine profile and found the following key results:
1. AMH: 0.47 ng/mL
2. Prolactin: 39.5 ng/mL (Reference: 4.79–23.3 ng/mL)
3. TSH (Ultrasensitive): 3.75 µIU/mL
4. Other normal parameters: Hemoglobin is 13 g/dL, HPLC Thalassemia screen is normal, Blood Group is O Positive, Fasting Blood Sugar is 89.78 mg/dL, and Kidney/Lipid profiles are normal.
5. Other abnormal findings: Urine Routine shows Nitrite and Bacteria present (Pus cells: 4/HPF), Alkaline Phosphatase is elevated at 590 U/L with Total Bilirubin at 1.64 mg/dL (though SGOT is 16.5 and SGPT is 11.6), and MCV is 104.4 fL.
Could you please guide us on:
1. What treatment should we start immediately to lower her Prolactin (39.5) and bring her TSH (3.75) below 2.5 for pregnancy?
Answers (2)
Fr borderline raised prolactin
Timing of collection of sample is important
If collected within 3 hours of getting up
She needs treatment
U can connect for a prescription
Tsh is raised needs treatment
At this poor amh
Chances of Natural conception looks bleak
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+101
Dr. Ankita Gahlot
Obstetrician
12 yrs exp
Bangalore
An AMH of 0.47 at 42 means her egg reserve is significantly reduced for her age, so timing matters here. Both the raised prolactin and the TSH above 2.5 can affect ovulation, and both are treatable with medicines her doctor will dose and recheck over a few weeks. The urine report showing nitrite, bacteria and pus cells points to a urinary infection that should be treated before you start trying.
Next Steps
See a fertility specialist soon alongside her physician, given her age and AMH together. Reserve like this can decline further with delay, so timing matters. Also ask about rechecking B12 or folate, since a high MCV often points there rather than the liver.
Health Tips
The mildly raised ALP with normal liver enzymes is usually not a liver problem, but mention it to her doctor alongside the B12 check.
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.