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Why did I have a miscarriage?

Q: I am 25 years old and have been married for 1.5 years. We are planning for a baby and have visited a gynaecologist who told us that my prolactin levels were elevated. I have always had regular periods. My thyroid levels including my FSH and TSH were normal but the prolactin levels were as high as 41. I was started with Cabergolin after which the prolactin levels fell. With monitoring and USG, I was pregnant naturally but had an immediate miscarriage at 5 weeks. What would be the reason for this and why were my prolactin levels high? My doctor has asked me to continue Cabergolin although my levels have gone down. Will I have problems in conceiving again? I have normal periods and my cycle length is 30 days.

A:There could be numerous reasons for the miscarriage. Two important ones at this stage of pregnancy are inadequate levels of progesterone (requiring supplementation during pregnancy) and chromosomal anomalies in the conceptus (which need not necessarily get repeated in next pregnancy). It is best to avoid another pregnancy for atleast 4- 5 months after your abortion. Also, it is good to take folic acid (1 tablet of Folvite daily) for 3 months prior to your next pregnancy and continue it through your pregnancy. If your prolactin levels are again high, you need to take Cabergolin.

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