Fertility and sterility · 1993
Occult hyperprolactinemia in infertile women.
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Asukai K, Uemura T, Minaguchi H
Аннотация
OBJECTIVE: To define the hypersensitive status of PRL secretion in normoprolactinemic infertile women and determine the incidence of occult hyperprolactinemia among them.
DESIGN: The potential for PRL secretion was examined in 463 women.
SETTING: Outpatient clinic in a university hospital.
PATIENTS: Three hundred sixty-seven infertile women and 96 healthy volunteers.
INTERVENTIONS: Patients were treated with bromocriptine, 2.5 or 5 mg/d for 3 months.
MAIN OUTCOME MEASURES: Prolactin response to thyrotropin-releasing hormone (TRH), circadian rhythm, and serum PRL changes during the menstrual cycle.
RESULTS: Approximately 15% of infertile women showed an exaggerated response to TRH, and 95% among them had clinical disorders such as galactorrhea, luteal insufficiency, and menstrual disturbances. Bromocriptine proved effective in 90% of these women. Transient hyperprolactinemia was observed at night in 80% of normal PRL responders who had galactorrhea. Bromocriptine was effective in 75% of these women. Transient hyperprolactinemia during the menstrual cycle was observed in 43% of normal PRL responders with luteal insufficiency, 85% of whom responded to treatment with bromocriptine.
CONCLUSION: In infertile women, the TRH test helps in the selection of patients who may respond to bromocriptine. Among normal PRL responders, 60% of patients with galactorrhea and 47% of those with luteal insufficiency recovered after bromocriptine treatment. From these results, patients who exhibit clinical abnormalities such as galactorrhea and luteal insufficiency should undergo extensive PRL testing.
DESIGN: The potential for PRL secretion was examined in 463 women.
SETTING: Outpatient clinic in a university hospital.
PATIENTS: Three hundred sixty-seven infertile women and 96 healthy volunteers.
INTERVENTIONS: Patients were treated with bromocriptine, 2.5 or 5 mg/d for 3 months.
MAIN OUTCOME MEASURES: Prolactin response to thyrotropin-releasing hormone (TRH), circadian rhythm, and serum PRL changes during the menstrual cycle.
RESULTS: Approximately 15% of infertile women showed an exaggerated response to TRH, and 95% among them had clinical disorders such as galactorrhea, luteal insufficiency, and menstrual disturbances. Bromocriptine proved effective in 90% of these women. Transient hyperprolactinemia was observed at night in 80% of normal PRL responders who had galactorrhea. Bromocriptine was effective in 75% of these women. Transient hyperprolactinemia during the menstrual cycle was observed in 43% of normal PRL responders with luteal insufficiency, 85% of whom responded to treatment with bromocriptine.
CONCLUSION: In infertile women, the TRH test helps in the selection of patients who may respond to bromocriptine. Among normal PRL responders, 60% of patients with galactorrhea and 47% of those with luteal insufficiency recovered after bromocriptine treatment. From these results, patients who exhibit clinical abnormalities such as galactorrhea and luteal insufficiency should undergo extensive PRL testing.