Relationship between hyperprolactinemia and infertility

Hyperprolactinemia refers to the level of prolactin (PRL) in the blood being higher than normal. Currently, it is generally considered to include explicit hyperprolactinemia and latent hyperprolactinemia. The former refers to a continuous increase in 24-hour blood PRL, while the latent refers to a transient increase in PRL value during sleep at night or during a certain period of the cycle. So, what is the relationship between hyperprolactinemia and infertility?

Clinical manifestations of infertility or sterility related to abnormal PRL secretion include amenorrhea, galactorrhea, oligomenorrhea and oligomenorrhea, corpus luteum insufficiency and follicular dysfunction, all of which may be the result of HPRL. Common PRL metabolic abnormalities include pituitary adenomas or PRL adenomas that secrete PRL, idiopathic or functional HPRL, and empty sella syndrome. Another type of infertility related to abnormal PRL secretion is called primary prolactin secretion abnormality, that is, cyclical or transient HPRL, and its exact impact on reproductive function remains to be clarified. Diseases related to secondary abnormal PRL secretion and causing infertility include polycystic ovary syndrome and primary hypothyroidism. These diseases can all be manifested as PRL metabolic disorders in clinical practice. Therefore, when infertility caused by HPRL is confirmed, differential diagnosis should be emphasized to make correct treatment.

PRL is a dynamic stress hormone, and its secretion is unstable. It may change due to different physiological conditions, such as sleep, mood, depression, tension, exercise, sexual intercourse, hunger and after eating, etc., which may affect its secretion state. In order to exclude the above influencing factors, it is generally advisable to draw blood on an empty stomach at 9-10am in the morning to measure the PRL level in blood. Normal PRL of women of childbearing age should be 5-25ng/ml. If it is 35ng/ml, PRL is elevated. If the PRL level is found to be elevated in the first measurement of infertile women, a second examination should be conducted, and HPRL should not be diagnosed easily. For those who have been confirmed to be HPRL, T4 and TSH levels should be measured to exclude hypothyroidism. Such patients often show normal thyroid function but TSH may be elevated, abnormal BBT graph, low P level in the mid-luteal phase, endometrial biopsy is often out of sync with endocrine levels, and poor follicular development monitored by B-ultrasound.

The above is an introduction to the relationship between hyperprolactinemia and infertility. I hope it will be helpful to you.