Effects of clomiphene citrate and leuprolide acetate on luteal-phase hyperprolactinemia during ovarian stimulation with menopausal gonadotropins

Impact of Transitory Hyperprolactinemia on Clinical Outcome of In Vitro Fertilization and Embryo Transfer

This study aimed to evaluate the impact of serum prolactin concentration at the day of human chorionic gonadotropin (HCG) administration on the clinical outcome of in vitro fertilization and embryo transfer (IVF-ET). A total of 184 patients receiving the IVF-ET/ICSI-ET from October 2005 to March 2008 were retrospectively analyzed. Subjects were divided into four groups according to the serum prolactin concentration [<30 ng/mL (A), 30-60 ng/mL (B), 60-90 ng/mL (C), ≥90 ng/mL (D)] on the day of HCG administration during controlled ovarian stimulation (COS). In the Groups A, B, C and D, the implantation rate was 11.76%, 19.71%, 12.72% and 2.22%, respectively, and the pregnancy rate (PR) was 25.00%, 42.70%, 27.30% and 5.88%, respectively. The implantation rate and PR in the Group D were markedly lower than those in the remaining groups (P=0.011 and 0.009). During the COS, the serum prolactin concentration was dramatically elevated when compared with the baseline level leading to transient hyperprolactinemia. In addition, the implantation rate and pregnancy rate were significantly markedly decreased when the serum prolactin concentration was remarkably increased (≥90 ng/mL). To improve the clinical pregnancy rate of IVF-ET, close monitoring and appropriate intervention are needed for patients with an abnormal prolactin level during the COS.

Influence of midluteal serum prolactin on outcome of pregnancy after IVF-ET: a preliminary study

PURPOSE

To investigate the relationship between serum prolactin levels in the midluteal phase and the prognosis of pregnancy after IVF-ET.

METHODS

DESIGN

Prospective study;

SETTING

Shimane Medical University Hospital;

PATIENTS

29 patients completing their 34th IVF cycle; and

MAIN OUTCOME MEASURES

Serum levels of prolactin, estradiol-17 beta, and progesterone in the midluteal phase.

RESULTS

Midluteal prolactin levels were significantly lower in patients with early pregnancy loss than in the successful pregnancy group. The mean progesterone/prolactin ratio and the estradiol-17 beta/prolactin ratio were highest in patients with early pregnancy loss and were lowest in patients with successful pregnancies.

CONCLUSIONS

Findings of this study suggest that measurement of the serum prolactin concentration in the midluteal phase is useful for predicting the outcome of IVF-ET.