Hyperprolactinaemia among infertile patients and its effect on sperm functions

Area of Science:

• Reproductive Endocrinology
• Andrology
• Clinical Biochemistry

Background:

• Hyperprolactinemia, elevated serum prolactin, is a condition that can affect male reproductive health.
• Its specific impact on sperm parameters in infertile men without overt symptoms is not fully understood.

Purpose of the Study:

• To investigate the effects of hyperprolactinemia on sperm function in infertile men.
• To determine the prevalence of hyperprolactinemia in this population and identify potential causes.
• To assess the impact of prolactin normalization on sperm parameters and fertilizing ability.

Main Methods:

• Studied 264 infertile men with abnormal sperm analyses (oligozoospermia, asthenozoospermia, teratozoospermia).
• Measured serum prolactin levels multiple times; diagnosed hyperprolactinemia (> or = 10 ng/mL).
• Investigated drug-induced hyperprolactinemia (cimetidine, anti-anxiety drugs) and pituitary microadenomas; monitored sperm parameters and used the hamster test for fertilizing ability.

Main Results:

• Hyperprolactinemia was diagnosed in 5.7% of patients.
• 12 cases were drug-induced (cimetidine, anti-anxiety drugs), resolving upon drug cessation.
• 3 cases were due to pituitary microadenomas, treated with bromocriptine.
• No significant changes in sperm concentration, motility, or morphology were observed after prolactin normalization.
• Sperm fertilizing ability did not improve in patients with pituitary microadenomas after treatment.

Conclusions:

• Asymptomatic hyperprolactinemia has a limited effect on sperm function impairment in infertile men.
• Measuring serum prolactin in infertile men is valuable for the early detection of pituitary microadenomas.
• Identifying and managing causes of hyperprolactinemia, including drug-induced cases, is important.