ASSOCIATION BETWEEN HYPERPROLACTINAEMIA AND OTHER CAUSES OF FEMALE INFERTILITY
Abstract
Hyperprolactinaemia is one of the major causes of reproductive axis disorders. Adequate treatment for hyperprolactinaemia is very successful in restoring ovulation, but there is still a proportion of patients unable to achieve pregnancy despite adequate control of hyperprolactinaemia. This prospective clinical trial included 104 hyperprolactinaemic patients in reproductive age: 78/104 (75%) suffered from infertility and the other 26 hyperprolactinaemic patients were still unmarried and not interested in pregnancy. Hyperpolactinaemia as the only reason for anovulation and infertility was diagnosed in 43/78 (55.12%) of our patients. In 35/78 (44.88%) patients, hyperprolactinaemia was associated with other causes of infertility: endometriosis, premature ovarian failure, PCO and insulin resistance, etc. After the appropriate treatment, mostly with bromocriptine (in 69/78 – 88.46%, alone or in combination with induction of ovulation), 35/78 (44.87%) patients achieved pregnancy. In the group of infertile patients with hyperolactinaemia as the only cause of infertility, 33/43 (76.74%) patients became pregnant, and in the group of patients who had combination of hyperprolactinaemia and other causes of infertility only 2/35 (5.71%) achieved pregnancy. The treatment of hyperprolactinaemia is obligatory in all patients with infertility. If adequate suppression of serum prolactin levels is achieved, but the pregnancy is still missing despite the fact that ovulatory cycles are established, the other causes of infertility should be searched for, and the clinician should not reject the possible existence of some unknown cause of infertility, so the patient should be referred to ART procedures which give more chances in such circumstances.
Key words: Hyperprolactinaemia, infertility, bromocriptine, assisted reproductive techniques
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