The influence of transient hyperprolactinemia on hormonal parameters, oocyte recovery, and fertilization rates in in vitro fertilization

  • Yael Gonen
  • Robert F. Casper
Special Contributions


A detrimental effect of transient elevation of plasma prolactin (PRL) during in vitro fertilization (IVF) has not been proven; however, treatment with a dopamine agonist has been suggested. The present study was undertaken to determine if transient, midcycle hyperprolactinemia exerted a deleterious effect on the number of oocytes retrieved or on fertilization of oocytes in vitro. Fifty-three infertile patients with midcycle hyperprolactinemia (PRL>20 μg/liter) during ovarian hyperstimulation for IVF were compared with 53 matched controls who remained normoprolactinemic. Mean (±SE) serum PRL levels on the day after hCG were significantly higher in the study group (29.5±1 μg/liter) than in the control (13.1±0.5 μg/liter) (P<0.0005), whereas the mean estradiol (E2) concentrations on the same day were not significanily different (4822±287 and 4492±269 pmol/liters, respectively). Fertilization rates (72±4 and 70±4%, respectively) and the mean number of oocytes recovered (4.2±0.3 and 3.7±0.3, respectively) did not differ between the two groups. No correlation was observed between serum PRL and E2 levels, fertilization rates, or the number of oocytes retrieved in either group. Eleven patients with elevated PRL levels as a result of ovarian hyperstimulation were treated with 2.5 mg bromocriptine daily during the next IVF cycle. Serum PRL levels were significantly lower in the treated (5.6±1.8 μg/liter) than in the untreated cycles (35.6±3.1 μg/liter) (P<0.0005), whereas serum E2 concentrations did not differ. Although the mean number of oocytes recovered was significantly higher in the treated (6.2±1.1) than in the untreated (4.7±0.7) (P<0.02) cycles, the fertilization rates were significantly lower when the patients were treated with bromocriptine compared with the previous untreated cycle (55±8.0 and 76.5±7.0%, respectively;P<0.05). Our data demonstrate that a transient elevation of PRL during ovarian stimulation for IVF does not adversely affect the endocrine response, number of oocytes retrieved, or fertilization rates. No improvement in these parameters was observed in bromocriptine-treated cycles. These results do not support the treatment of transient hyperprolactinemia with dopamine agonists in IVF patients.

Key Words

prolactin bromocriptine ovarian stimulation oocyte recovery fertilization 


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  1. 1.
    McNatty KP, McNeilly AS, Sawers RS: Prolactin and progesterone secretion by human granulosa cells in vitro.In Prolactin and Human Reproduction, Serono Symposia Proceedings, Vol 11, PG Crosignani, C Robyn (eds), New York, Academic Press, 1977Google Scholar
  2. 2.
    Kauppila A, Leinonen P, Vihko R, Ylostalo P: Metoclopramide-induced hyperprolactinemia impairs ovarian follicle maturation and corpus luteum function in women. J Clin Endocrinol Metab 1982;54:955–960PubMedGoogle Scholar
  3. 3.
    Blankstein J, Mashiach S, Lunenfeld B: Ovulation Induction and in Vitro Fertilization. Year Book Medical, Chicago, 1986, p 80Google Scholar
  4. 4.
    Kauppila A, Kirkinen P, Orava M, Vihko K. Effects of metoclopramide-induced hyperprolactinemia during early follicular development on human ovarian function. J Clin Endocrinol Metab 1984;59:875–880PubMedGoogle Scholar
  5. 5.
    Ben David M, Shenker JG: Transient hyperprolactinemia: A correctable cause of idiopathic female infertility. J Clin Endocrinol Metab 1983;57:442–444PubMedGoogle Scholar
  6. 6.
    Forman R, Fischel SB, Edwards RG, Walters E: The influence of transient hyperprolactinemia on in vitro fertilization in human. J Clin Endocrinol Metab 1985;60:517–522PubMedGoogle Scholar
  7. 7.
    Reinthaller A, Bieglmayer CH, Deutinger J, Csaicsich P: Transient hyperprolactinemia during cycle stimulation: Influence on the endocrine response and fertilization rate of human oocytes and effects of bromocriptine treatment. Fertil Steril 1988;49:432–436PubMedGoogle Scholar
  8. 8.
    Kauppila A, Matikainen M, Ristola U, Reinila M, Ronnberg L. Hyperprolactinemia and ovarian function. Fertil Steril 1988;49:437–441PubMedGoogle Scholar
  9. 9.
    Wood C, Trounsen A (eds). Clinical in Vitro Fertilization. Berlin, Springer-Verlag, 1984Google Scholar
  10. 10.
    Cutie RE, Nieves AA. Prolactin inhibits the steroidogenesis in midfollicular phase human granulosa cells cultured in a chemically defined medium. Fertil Steril 1988;49:632–637PubMedGoogle Scholar
  11. 11.
    Fukuda A, Noda Y, Mori Y, Mori CH, Hashimoto H, Hoshino K. Effects of prolactin on gamets and zygotes during in vitro fertilization. J Vitro Fert Embryo Transfer 1988;5:25–30Google Scholar
  12. 12.
    McNatty KP, Hunter WM, McNeilly AS, Sawers RS: Changes in the concentration of pituitary and steroid hormones in the follicular fluid of human Graafian follicles throughout the menstrual cycle. J Endocrinol 1975;64:555–571PubMedGoogle Scholar
  13. 13.
    McNeilly AS, Glasir A, Janassen J, Howie P: Evidence for direct inhibition of ovarian function by prolactin. J Reprod Fertil 1982;65:559–569PubMedGoogle Scholar
  14. 14.
    Boyers SP, Lavy G, Russell JB, Polan ML, DeCherney AH: Serum prolactin response to embryo transfer during human in vitro fertilization and embryo transfer. J Vitro Fert Embryo Transfer 1987;4:269–272Google Scholar
  15. 15.
    Franchimont P, Dourcy C, Legros JJ, Reuter A, Vrindts-Gevaert Y, Van Cauwenberge JR, Gaspard U: Prolactin levels during the menstrual cycle. Clin Endocrinol (Oxford) 1976;5:643–650Google Scholar
  16. 16.
    Buckman MT, Peak GT, Srivastava SL: Periovulatory enhancement of spontaneous prolactin secretion in normal women. Metabolism 1980;29:753–757PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1989

Authors and Affiliations

  • Yael Gonen
    • 1
    • 2
  • Robert F. Casper
    • 1
  1. 1.Division of Reproductive Science, Department of Obstetrics & GynecologyUniversity of TorontoToronto, Ontario, Canada
  2. 2.Department of Obstetrics & GynecologyCarmel HospitalHaifaIsrael

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