Abstract
BackgroundTransient hyperprolactinemia was proven to adversely affect the outcome of IVF. We aimed to identify changes in serum prolactin levels in patients undergoing ICSI, and to evaluate the effect of these changes on the clinical pregnancy rate.MethodsA prospective observational study included 90 patients scheduled for ICSI cycles. In each case 4 serum samples were collected during the cycle (midluteal, before ovum pick up procedure (OPU), 2 h after OPU, and before embryo transfer). Serum prolactin level was determined by immunoassay each time.ResultsThe sample collected 2 h after OPU had a mean difference of 25.8 ± 2.8 ng/ml compared to the basal serum prolactin (p < 0.01). In comparison to other samples, this highlighted a significant hyperprolactinemia occurring after OPU, and resolving before embryo transfer. No statistically significant difference between the different serum prolactin samples amongst the pregnant and non pregnant patients. There was a significant positive pearson correlation between the prolactin levels before OPU, and the presence of higher quality embryos (r = 0.274, p = 0.019).ConclusionIn normoprolactinemic women transient hyperprolactinemia is identified in patients undergoing ICSI, and it doesn’t affect the clinical pregnancy rates. A positive correlation was identified between higher quality embryos, and serum prolactin level before OPU.Trial registrationClinicalTrials.gov Identifier: NCT02292953, First received: November 10, 2014.
Highlights
Transient hyperprolactinemia was proven to adversely affect the outcome of in-vitro fertilization (IVF)
The secretion of endometrial prolactin helps in maintaining endometrial receptivity, and has been shown to provide an optimal environment for the implanting blastocyst transferred during in-vitro fertilization (IVF) cycles
Our results showed that elevated serum prolactin identified after ovum pick up procedure (OPU) had no significant impact on pregnancy, as did the results from previous work by Doldi et al
Summary
Transient hyperprolactinemia was proven to adversely affect the outcome of IVF. We aimed to identify changes in serum prolactin levels in patients undergoing ICSI, and to evaluate the effect of these changes on the clinical pregnancy rate. Prolactin (PRL) is a 198 amino acid polypeptide hormone secreted in a pulsatile manner from the anterior pituitary, and is synthesized by lactotroph cells. It weighs 23 kDa, and its secretion is affected by many factors which include stress, sleep, pregnancy, ingesting food, and chest wall stimulation (trauma, or pain). A high enough prolactin level can inhibit the proliferation of luteinizing granulosa cells, and can interfere with corpus luteum function resulting in luteal phase defect, as well as abnormal implantation, and embryo development [2]. Different studies have proven the existence of a state of hyperprolactinemia during IVF/Intracytoplasmic sperm injection (ICSI) cycles [3, 4]
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