Prevalence of hyperprolactinemia in infertile women and its association with hypothyroidism

Authors

  • Saranya Nallusamy Department of Obstetrics & Gynaecology, A.C.S Medical College and Hospital, Chennai, India
  • Leila J. Gracelyn Department of Obstetrics & Gynaecology, A.C.S Medical College and Hospital, Chennai, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20151533

Keywords:

Hyperprolactinemia, Infertility, Hypothyroidism, Galactorrhea

Abstract

Background: Hyperprolactinemia is one of the common endocrinological disorders affecting fertility by causing anovulatory cycles, luteal phase defect and sex hormone imbalances. There is higher incidence of hyperprolactinemia among infertile females. So estimation of serum prolactin should be done at an early stage of infertility workup which is cost effective and causes better outcome. The objective of this study was to find out the prevalence of hyperprolactinemia in female infertility after excluding tubal factor and male factor and to find its correlation with hypothyroidism.

Methods: Hospital based analytical cross sectional study was conducted for 1½ years, among 300 infertile females. Females with primary and secondary infertility. Male factor infertility, females with tubal factor, history of thyroid disease/thyroid surgery/thyroid medication.

Results: Prevalence of hyperprolactinemia that is serum prolactin > 25µg/L was 24.67%.The mean serum prolactin level in hyperprolactinemic females was 84.83µg/L. Incidence of hypothyroidism in hyperprolactinemia was 25.68%.Obesity (BMI >25) was present in 26% Galactorrhea was present in 20.27% females. Obesity and galactorrhea had strong positive correlation with hyperprolactinemia. Among the 300 females, 239 (79.6 %) had primary infertility and 61(20.4%) had secondary infertility.

Conclusions: Hyperprolactinemia alters the hypothalamopituitary ovarian axis and causes reproductive dysfunction. In our study, the prevalence of hyperprolactinemia was found to be high among infertile females. The relatively high occurrence of hypothyroidism among infertile females emphasizes the importance of estimating both serum prolactin and TSH in infertility.

References

Unuane D, Tournaye H, Velkeniers B, Poppe K. Endocrine disorders & female infertility. Best Prac Res Clin Endocrinol Metab. 2011;25(6):861-73.

Rosato F, Garofalo P. Hyperprolactinemia: from diagnosis to treatment. Minerva pediatrica. 2002;54(6):547-52.

Ratner LD, Gonzalez B, Ahtiainen P, Di Giorgio NP, Poutanen M. Short-term pharmacological suppression of the hyperprolactinemia of infertile hCG-overproducing female mice persistently restores their fertility. Endocrinology. 2012;153(12):5980-92.

Berinder K, Hulting AL, Granath F, Hirschberg AL, Akre O. Parity, pregnancy and neonatal outcomes in women treated for hyperprolactinaemia compared with a control group. Clin Endocrinol. 2007;67(3):393-7.

Poppe K, Velkeniers B. Thyorid disorders in infertile women. Ann Endocriniol (Paris). 2003;64(1):45-50.

Zollner U, Lanig K, Steck T, Dietl J. Assessment of endocrine status in patients undergoing in-vitro fertilization treatment. Is it necessary? Arch Gynecolo obstet. 2001;265(1):16-20.

Avasti kumkum,kaur jasmine,Gupta Shweta. Hyperprolactinemia and its correlation with hypothyroidism in infertile women J obstet gynecol India. 2006;56:68-71.

Eldin S, Abdelghani A, Elmagadum A. Hyperprolactinemia as a cause of female infertility and its prevalence in central Sudan. Egypt Acad. J.Biolog. Sci. 2013;5(1):31-6.

Shoupe D, Mishell DR. Hypoprolactinemia: Diagnosis and treatment. In: Mishell‘s textbook of Infertility, Contraception and Reproductive Endocrinology.. Massachusetts. Blackwell Science. 1997;4:323-41.

Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA. Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2011;96:273-88.

Serri O, Chik CL, Ehud Ur, Ezzat S. Diagnosis and management of hyperprolactinemia. Canadian Medical Association Journal. 2003;169(6):575-81.

Barclay L, Lie D. Endocrine Society Issues Guidelines for Management of Hyperprolactinemia. J Clin Endocrinol Metab. 2011;96:273-88.

Misra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS, Chadha D. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc. Physicians India. 2009;57:163-70.

Choudhary SD, Goswami A. Hyperprolactinemia and reproductive disorder a profile from north east. J Assoc Physicians India. 1995;43:617-8.

Goswami B, Patel S, Saxena A. correlation of prolactin and thyroid hormone concentration with menstrual pattern in infertile women. J Reprod Infertility. 2009;10(3):207-12.

Akhter N, Hassan S. Sub-clinical hypothyroidism and hyperprolactinemia in infertile women: Bangaladesh perspective after universal salt iodination. the internet journal of endocrinology. 2008;5(1).

Verma I, Sood R, Juneja S, Kaur S. Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility. Int J Appl Basic Med Res. 2012;2(1):17-9.

Muhammad O, Bushra J. Physiological study of some Hormonal Parameters in Infertile Hyperprolactinemic Women in Pre and Post Treatment with Cabergoline and Bromocriptine. Medical journal of Babylon. 2012;9(2):349-61.

Sharma N, Baliarsingh S, Kaushik GG. Biochemical association of hyperprolactinemia with hypothyroidism in infertile women. Clin Lab. 2012;58(7-8):805-10.

Dizerega GS, Ross GT. Luteal phase dysfunction. Clin Obstet Gynecol. 1981;8:733-51.

Shibli-Rahhal A, Schlechte J. Hyperprolactinemia and infertility. Endocrinol Metab Clin N Am. 2011;40:837-46.

Crosignani PG. Management of hyperprolactinemic infertility. Middle East Fertility Society Journal. 2012;17:63–69.

Singh L, Agarwal CG, Chowdhary SR. Thyorid profile in infertile women. J. Obstet Gynecol India. 1990;40:248-53.

Souter I, Baltagi LM, Toth TL, Petrozza JC. Prevalence of hyperprolactinemia and abnormal magnetic resonance imaging findings in a population with infertility. Fertil Steril 2010;94:1159-62.

Seth B, Arora S, Singh R. Association of Obesity with Hormonal Imbalance in Infertility-A Cross-Sectional Study in North Indian Women. Ind J Clin Biochem. 2013;28(4):342-7.

Ernst B, Thurnheer M, Schultes B. Basal serum prolactin levels in obesity—unrelated to parameters of the metabolic syndrome and unchanged after massive weight loss. Obes Surg. 2009;19(8):1159-62.

Grimaldi F, Mazzolini A, Paterniti BR, Torossi I, Proto G, Bertolissi F. Changes in secretion of prolactin in obesity. Minerva Endocrinol. 1990;15(4):267-71.

Downloads

Published

2017-01-05

Issue

Section

Original Research Articles