الفهرس 
The association between serum prolactin levels and pregnancy outcomes in in vitro fertilization intracytoplasmic sperm injection cycle
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Abstract
Objective: To investigate the effect of different basal prolactin levels less than 50 ng/ml
on IVF/ICSI cycles outcome in a selected group of women undergoing IVF/ICSI cycles.
Background: Prolactin (PRL) is a polypeptide hormone that is responsible for milk
production, development of mammary glands and hundreds of other actions. In adult nonpregnant woman, serum PRL level above 25 ng/ml is considered hyperprolactinemia.
Hyperprolactinemia has been considered detrimental to fertility due to its effect on
blocking LH secretion leading to anovulation. Therefore, it is a common practice for
clinicians to measure prolactin levels as part of the fertility investigations and prescribe
treatment in cases with high PRL levels in particular before IVF/ICSI cycles. Unlike
hyperprolactinemia due to an organic cause, basal high PRL levels before starting IVF/ICSI
cycles remains challenging to clinicians. There is conflicting evidence regarding the effect
of hyperprolactinemia on IVF/ICSI outcome. Previous studies showed that the effect of
hyperprolactinemia during IVF is insignificant, while others demonstrated a positive effect
of increased serum PRL levels on the outcome of ovarian stimulation in IVF/ICSI cycles.
Other studies have proved that high prolactin levels adversely affect outcome of IVF/ICSI
cycles.
Methods: The selected cases were classified into 3 groups according to their basal serum
PRL levels, group A that included 25 cases with prolactin (PRL) < 20 ng/ml, group B that
included 25 cases with PRL level between 20 - 25 ng/ml and group C that included 29
cases with PRL > 25 ng/ml and not treated by cabergoline. Clinical pregnancy rate was
evaluated and considered as the primary outcome of the study. Implantation rate, the
number of oocytes retrieved, number of mature oocytes (M2) and grading of embryos
(number of good embryos) were evaluated and considered as the secondary outcome of the
study.
Results: The mean age was statistically significant lower in the women with basal PRL
levels more than 25 ng/ml. After adjusting for age, there were no statistically significant
differences found in primary or secondary outcome measures of the IVF cycles between
the selected groups.
Conclusion: Clinical pregnancy rates in women undergoing IVF/ICSI cycles are not
affected by higher basal prolactin (PRL) levels when PRL is less than 50 ng/ml. And so,
further studies are required to detect the proper level of PRL