[Mild hyperprolactinemia in assisted fertilization]

The impact of mild hyperprolactinemia (serum prolactin <50 ng/mL) on assisted reproductive outcomes remains controversial. For that reason, we aimed to compare pregnancy and live birth rates in a cohort of women with untreated mild hyperprolactinemia versus women with normal prolactin levels (<26.5 ng/mL) undergoing high complexity assisted reproductive techniques.

This was a retrospective study conducted between 2011 and 2021, including women under 40 years of age with infertility due to tubal factor, male factor, or unexplained infertility (UI) who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Pregnancy and live birth rates were compared between two groups: women with normal prolactin levels and those with untreated mild hyperprolactinemia (not receiving dopamine agonist therapy).

A total of 242 patients were included; 82% (n=199) had normal prolactin levels and 18% (n=43) had mild hyperprolactinemia. Of these, 31.1% (n=76) underwent IVF and 68.9% (n=166) underwent ICSI. The pregnancy rate was 37.8% (n=74) in the normal prolactin group and 67.5% (n=27) in the mild hyperprolactinemia group (p=0.001). After adjusting for overweight status, age, and infertility etiology, women with mild hyperprolactinemia had threefold higher odds of achieving pregnancy compared with those with normal prolactin levels (p=0.004). No significant differences were observed in live birth rates between groups (p=0.4).

In women undergoing IVF or ICSI, mild hyperprolactinemia did not adversely affect assisted fertilization outcomes. On the contrary, it was associated with a significantly higher pregnancy rate.