SERUM PROLACTIN LEVELS AND HYPERPROLACTINEMIA AMONG WOMEN UNDERGOING INFERTILITY EVALUATION IN BANGLADESH
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Keywords
Hyperprolactinemia, Serum prolactin, Female infertility, Galactorrhoea
Abstract
Introduction: Hyperprolactinemia is a common, correctable endocrine disturbance that disrupts gonadotropin-releasing hormone pulsatility and contributes to ovulatory dysfunction and infertility. Excess prolactin suppresses luteinizing hormone and follicle-stimulating hormone release, impairing folliculogenesis. Population-specific data on serum prolactin distribution among Bangladeshi women undergoing infertility evaluation remain limited.
Objective: To determine the serum prolactin profile and prevalence of hyperprolactinemia and to examine its association with type of infertility and baseline clinical characteristics, among women attending an infertility clinic in Bangladesh.
Methods: This cross-sectional observational study was conducted in the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from January to December 2010 and included 120 women undergoing infertility evaluation. Structured interview, clinical examination and fasting serum prolactin estimation were performed. Hyperprolactinemia was defined as a level above 25 ng/mL. Data were analyzed using SPSS version 16.0, with the independent samples t-test and chi-square test applied appropriately.
Results: Mean age was 29.4 ± 5.2 years and primary infertility was present in 74.2%. Mean serum prolactin was 17.4 ± 10.2 ng/mL and hyperprolactinemia were found in 16.7% of women. Prolactin levels and hyperprolactinemia prevalence were comparable between primary and secondary infertility (p = 0.918). No significant association was found between hyperprolactinemia and age, body mass index, menstrual pattern, or duration of infertility, though galactorrhoea showed a borderline association (30.0% vs. 13.0%, p = 0.06).
Conclusion: Hyperprolactinemia affected a substantial minority of women undergoing infertility evaluation, independent of menstrual pattern or infertility type, supporting routine prolactin screening in the basic infertility work-up.
References
2.Bole-Feysot C, Goffin V, Edery M, Binart N, Kelly PA. Prolactin (PRL) and its receptor: actions, signal transduction pathways and phenotypes observed in PRL receptor knockout mice. Endocr Rev. 1998;19(3):225-268.
3.Serri O, Chik CL, Ur E, Ezzat S. Diagnosis and management of hyperprolactinemia. CMAJ. 2003;169(6):575-581.
4.Majumdar A, Mangal NS. Hyperprolactinemia. J Hum Reprod Sci. 2013;6(3):168-175.
5.Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009;92(5):1520-1524.
6.Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod. 2007;22(6):1506-1512.
7.World Health Organization. Infertility: A Tabulation of Available Data on Prevalence of Primary and Secondary Infertility. Geneva: World Health Organization; 1991.
8.Kars M, van der Klaauw AA, Onstein CS, Pereira AM, Romijn JA. Estimated age- and sex-specific incidence and prevalence of dopamine agonist-treated hyperprolactinemia. J Clin Endocrinol Metab. 2009;94(8):2729-2734.
9.Bahamondes L, Faundes A, Tambascia M, Trevisan M, Dachs JN, Pinotti JA. Menstrual pattern and ovarian function in women with hyperprolactinemia. Int J Gynaecol Obstet. 1985;23(1):31-36.
10.Eftekhari N, Mirzaei F, Karimi M. The prevalence of hyperprolactinemia and galactorrhoea in patients with abnormal uterine bleeding. Gynecol Endocrinol. 2008;24(5):289-291.
11.Zain MM, Norman RJ. Impact of obesity on female fertility and fertility treatment. Womens Health (Lond). 2008;4(2):183-194.
12.Rich-Edwards JW, Spiegelman D, Garland M, Hertzmark E, Hunter DJ, Colditz GA, et al. Physical activity, body mass index and ovulatory disorder infertility. Epidemiology. 2002;13(2):184-190.
13.te Velde ER, Pearson PL. The variability of female reproductive ageing. Hum Reprod Update. 2002;8(2):141-154.
14.Practice Committee of the American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril. 2012;98(2):302-307.
15.Biller BM. Hyperprolactinemia. Int J Fertil Womens Med. 1999;44(2):74-77.
16.Luciano AA. Clinical presentation of hyperprolactinemia. J Reprod Med. 1999;44(12 Suppl):1085-1090.
17.Pandey S, Pandey S, Maheshwari A, Bhattacharya S. The impact of female obesity on the outcome of fertility treatment. J Hum Reprod Sci. 2010;3(2):62-67.
18.Hekimsoy Z, Kafesçiler S, Güçlü F, Ozmen B. The prevalence of hyperprolactinaemia in overt and subclinical hypothyroidism. Endocr J. 2010;57(12):1011-1015.
19.Ferriani RA, Silva de Sá MF. Effect of venipuncture stress on plasma prolactin levels. Int J Gynaecol Obstet. 1985;23(2):143-147.
20.Verhelst J, Abs R. Hyperprolactinemia: pathophysiology and management. Treat Endocrinol. 2003;2(1):23-32.
21.Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA, et al. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(2):273-288.
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