[True and false hyperprolactinemia: how to discriminate one from the other in infertility management?]

Serum prolactin measurement is usually performed in infertility evaluation, even if there's no specific clinical presentation of hyperprolactinemia. High levels of prolactin are noted in 20 to 30% of menstrual abnormalities and in about 10% of regular menses. It is of importance to determine whether hyperprolactinemia is related to pituitary adenoma, drug administration, general diseases, or circulating large forms of prolactin, in order to avoid heavy, expensive, time consuming and unnecessary clinical investigations or therapeutic actions. We must first to confirm the biological diagnosis of hyperprolactinemia with few repeated plasmatic measurements, and, later, if necessary use TRH-metoclopramide test and/or pituitary magnetic resonance imaging.