Hyperprolactinemia in men with asthenozoospermia, oligozoospermia, or azoospermia

The role of serum prolactin (PRL) in male infertility is still unclear. To assess the clinical significance of PRL determination during infertility studies, serum hormones and semen samples from 167 men attending the Andrology Clinic were analyzed, and PRL seric values were correlated with volume, sperm count, motility, viability, and morphology. The range of PRL levels (ng/mL) was 7.3 +/- 2.1 in the control group (n = 46), 13.9 +/- 6.6 in asthenozoospermic (n = 51), 12.6 +/- 7.8 in oligozoospermic (n = 42), and 10.9 +/- 4.8 in azoospermic patients (n = 28). Significantly higher (p < .0001) levels of PRL were found in the men with asthenozoospermia, oligozoospermia, and azoospermia. In the 121 infertile patients with abnormal semen analysis, serum PRL levels were below 14.0 ng/mL (normal mean + 3 SD) in 81 (66.9%) and above this level in 40 (33.1%) cases. Serum FSH and LH concentrations in azoospermic men were significantly higher (p < .0001) when compared with those of the control group, which indicates some disturbance of the spermatogenic process, and estradiol was significantly higher (p < .02) in oligozoospermic patients. No significant differences were found in serum testosterone. Twenty-one patients with idiopathic oligoasthenozoospermia and hyperprolactinemia were treated with 2.5 mg of bromocriptine daily for 6 months, resulting in a nonmeasurable effect on their sperm analysis. In conclusion, two-thirds of patients with oligozoospermia, asthenozoospermia, and azoospermia have normal PRL levels. Infertility in men due to moderate hyperprolactinemia could be associated with these sperm disturbances, but bromocriptine was of no therapeutic utility.