PATTERN OF CLINICAL PRESENTATION OF HYPERPLOLACTINEMIA AMONG INFERTILE PATIENTS

Abstract

INTRODUCTION– The prevalence of hyperprolactinemia ranges from 0.4% in unselected normal adult females to as high as 9%–17% in females with reproductive health disorders.The etiology of hyperprolactinemia maybe pathological, physiological or pharmacological Drugs that stimulate the hypothalamic dopamine system and/or pituitary or dopamine receptors can cause elevated prolactin.Clinical features of hyperprolactinemia include menstrual disturbances (Oligo-amenorrhea, amenorrhea and irregular menses), anovulation, infertility galactorrhea or a combination of the above symptoms. MATERIAL AND METHOD- This is a retrospective of 88 Infertile females with documented Hyperprolectinimea.The clinical data and infertility workup (Hormonal profile, Imaging report and other tests)were obtained from gynaecological OPD. RESULTS- In this study the maximum number 54 (61.36%) of patientswere in the 21-25 years of age group,65 (73.86%) of patients were of normal weight and 20 (22.72%) of patients were overweight only 3 (3.40%) were obese In this study,the maximum number 60(68.18%)of patients were in primary infertility and 85 (96.59%) of patients had in mild rise in the prolactin level group. In this study, most of the patients 27 (30.68%) of patients were presented with complaints of oligomenorrheaand followed by Amenorrhea 21 (23.86%).Galactorrhea was found in 25(28.40%) patients after clinical examinations,both amenorrhea and galactorrhea were seen in20(22.72%)of the patients. Hypothyroidism was present in 13 (14.77%) of patients. CONCLUSION– Anovulatory cycle, Luteal face defect and sex hormonal imbalance caused by hyperprolactinemia results in infertility.Prolactin may stop ovulation and cause amenorrhea, in less severe cases Intermittent ovulation or ovulation that takes a long time to occur causes infrequent or irregular periods.that's why estimation of serum prolactin should be done at an early stage of an infertility workup. In our study, the prevalence of hyperprolactinemia and hypothyroidism was found very high which emphasize the importance of estimating TSH and Prolactin in infertility.In our study Oligomonorrhea,amenorrhea and galactorrhea are the commonest presentations in hyperprolactinemia.Proper Diagnosis and treatment results in an improvement in symptoms and an increase in conception rates in infertile patients.