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Occult hyperprolactinemia in infertile women
K Asukai1, T Uemura, H Minaguchi
1Department of Obstetrics and Gynecology, Yokohama City University, School of Medicine, Japan.
Fertility and Sterility
|September 1, 1993
Summary
Occult hyperprolactinemia affects infertile women, presenting as abnormal prolactin (PRL) secretion. Testing for this condition can identify patients who will benefit from bromocriptine treatment, improving fertility outcomes.
Area of Science:
- Reproductive endocrinology
- Infertility research
- Hormonal assays
Background:
- Infertile women may have undiagnosed prolactin secretion abnormalities.
- Hyperprolactinemia is a known cause of infertility.
- Subtle PRL dysregulation can impact reproductive health.
Purpose of the Study:
- To define hypersensitive prolactin (PRL) secretion in infertile women.
- To determine the incidence of occult hyperprolactinemia in this population.
- To assess the efficacy of bromocriptine treatment.
Main Methods:
- Examined PRL secretion potential in 463 women (367 infertile, 96 controls).
- Assessed prolactin response to thyrotropin-releasing hormone (TRH), circadian rhythm, and menstrual cycle changes.
- Treated patients with bromocriptine (2.5 or 5 mg/d) for 3 months.
Main Results:
- 15% of infertile women showed exaggerated TRH response, often with galactorrhea, luteal insufficiency, or menstrual issues.
- Bromocriptine was effective in 90% of these women.
- Transient hyperprolactinemia was noted in 80% of normal PRL responders with galactorrhea and 43% with luteal insufficiency, with bromocriptine efficacy of 75% and 85% respectively.
Conclusions:
- The TRH test aids in selecting infertile patients for bromocriptine therapy.
- Bromocriptine treatment led to recovery in 60% of patients with galactorrhea and 47% with luteal insufficiency.
- Extensive prolactin testing is recommended for infertile patients with galactorrhea or luteal insufficiency.