Abstrait

Serum prolactin status in primary infertile women

Hasna Hossain*

Background: Prolactin is a polypeptide hormone that is produced by the anterior pituitary gland. Prolactin stimulates milk production in women after the delivery of a baby. Physiologically during the first several months of breastfeeding, the high level of prolactin inhibits ovulation. But if women have abnormally high level of prolactin, it may cause infertility. Prolactin inhibits two hormones Follicle Stimulating Hormone (FSH) and Gonadrotropin Releasing Hormone (GnRH) which are necessary for ovulation and these results in infertility. Hyperprolactinemia is the risk factor of hypogonadism, infertility and galactorrhea of the women in reproductive age. Objectives: To see the relationship between serum prolactin and primary infertility. Method: This cross sectional comparative study was carried out in the Department of Obstetrics and Gynaecology, Dhaka Medical Collage Hospital, Dhaka and data were collected from sampling population, The infertile patients were selected from the out patients department of infertility center at DMCH. Control subjects were selected from personal contact. After selection of subjects the purpose of the study was explained to each subject with a cordial attitude given emphasis of the benefits they would obtain from the study. They were encouraged for the voluntary Participation. With all aseptic precaution 5.0 (five) ml of venous blood was drawn from the anticubetal vein by disposable plastic syringe in early morning. Blood was allowed to clot and then centrifuged at a rate of 3000 rpm and supernatant clear serum was separated and preserved at 2-8°C for further study. The serum prolactin measured by radioimmunoassay in the center for Nuclear Medicine and Ultrasound, Dhaka Medical Collage Hospital, Dhaka. Statistical analyses were carried out by using the Statistical Package for Social Sciences version for Windows (SPSS Inc., Chicago, Illinois, USA). Results: Among 102 cases the mean age was found 28.13 ± 4.79 years in group A and 26.49 ± 4.14 years in group B. Mean BMI was found 25.28 ± 3.33 kg/m2 in group A and 26.15 ± 2.49 kg/m2 in group B. In group B, 39(76.47%) patients had menstrual abnormality followed by 20(39.22%) had acne/hirsuitism, 15(29.41%) had dismenorrhea, 11(21.57%) had dysparonia, 10(19.61%) had asymptomatic and 2(3.92%) had galactorrhoea. Serum prolactin level 2-15 ng/ml among them 46(90.2%) in group A and 20(39.2%) in group B. Thirty (36) patients had serum prolactin level >15 ng/ml among them 31(60.8%) patients in group B. The difference was statistically significant (p<0.05) between the groups. Mean serum prolactin level was found 10.66 ± 4.87 ng/ml in group A and 20.06 ± 8.22 ng/ml in group B (p<0.05). Abnormal menstrual history was common in group B (76.47% vs 27.45%). Patients who had increased level of prolactin level their various from of abnormal menstrual history 27(87.1%) and normal menstrual history 04(12.9%). Mean serum prolactin level was found 15.62 ± 5.19 ng/mL in normal menstrual abnormality and 21.43 ± 8.55 ng/mL in abnormal menstrual abnormality. The mean serum prolactin level was found 40.68 ± 1.57 ng/mL in galactorrhoea and 19.22 ± 7.21 ng/mL in non galactorrhoea. Which were statistically significant (p<0.05). Mean serum prolactin level was found 22.08 ± 9.05 ng/mL in duration of primary infertility ≤5 years and 18.53 ± 7.32 ng/mL in duration of primary infertility >5 years. The difference was not statistically significant (p>0.05). Conclusion: In conclusion, that women with infertility had significantly higher serum prolactin than that of healthy parous woman. High level of prolactin may more prevelant in primary infertile women