Treatment versus no treatment of transient hyperprolactinemia in patients undergoing intracytoplasmic sperm injection programs

The aim of our study was to investigate the effect of increased plasma prol actin level on oocyte and fertilization rare in patients undergoing in vitr o fertilization (IVF) intracytoplasmic sperm injection (ICSI) treatment. We identificated 135 patients with transient or borderline hyperprolactinemia , measured in the mid and late follicular phase and in the mid-luteal phase of the cycle before ovarian stimulation. The patients were assigned to eit her the no treatment group (76 patients) or the treatment group (59 patient s). The treated group underwent treatment with cabergoline or bromocriptine before ovarian stimulation, until there was a decrease of plasma prolactin levels, and the therapy was continued also during the ICSI programme. Both groups received a gonadotropin-releasing hormone (GnRH) agonist and were s ubsequently stimulated with follicle-stimulating hormone (FSH) up to the da y of human chorionic gonadotropin (hCG) administration. The untreated group needed a significantly lower number of FSH ampoules tha n the treated group to reach the day of hCG administration (38.1 +/- 18.2 v ersus 43.9 +/- 28.5; p < 0.05). No correlation was found between the two groups on the peak estradiol level achieved, the progesterone level at hCG administration and the numbers of oocytes retrieved. The number of oocytes with superior morphology (87.9% ve rsus 80.4%; p < 0.05), the fertilization rate (70.8 +/- 28.0 versus 60.8 +/ - 28.5; p < 0.03), and the mean number of embryos transferred (3.6 +/- 1.6 versus 3.2 +/- 1.5; p < 0.05) were significantly higher in the patients who se hyperprolactinemia war left untreated. In conclusion, we found that transient hyperprolactinemia is positively ass ociated with ICSI outcome, in particularly with oocyte quality and fertiliz ation rate.