Doldi N, Papaleo E, De Santis L, Ferrari A
Department of Obstetrics and Gynecology, San Raffacle Scientific Institute, University of Milan, Milan, Via Olgettina 60, 20132, Italy.
Gynecol Endocrinol. 2000 Dec;14(6):437-41. doi: 10.3109/09513590009167716.
The aim of our study was to investigate the effect of increased plasma prolactin levels on oocyte and fertilization rate in patients undergoing in vitro fertilization (IVF) intracytoplasmic sperm injection (ICSI) treatment. We identified 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 either the no treatment group (76 patients) or the treatment group (59 patients). 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 subsequently stimulated with follicle-stimulating hormone (FSH) up to the day of human chorionic gonadotropin (hCG) administration. The untreated group needed a significantly lower number of FSH ampoules than the treated group to reach the day of hCG administration (38.1 +/- 18.2 versus 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% versus 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 whose hyperprolactinemia was left untreated. In conclusion, we found that transient hyperprolactinemia is positively associated with ICSI outcome, in particularly with oocyte quality and fertilization rate.
我们研究的目的是调查血浆催乳素水平升高对接受体外受精（IVF）卵胞浆内单精子注射（ICSI）治疗患者的卵母细胞及受精率的影响。我们识别出135例在卵巢刺激前周期的卵泡中期和晚期以及黄体中期测量出有短暂性或临界高催乳素血症的患者。这些患者被分为未治疗组（76例患者）和治疗组（59例患者）。治疗组在卵巢刺激前接受卡麦角林或溴隐亭治疗，直至血浆催乳素水平下降，并且在ICSI程序期间也继续该治疗。两组均接受促性腺激素释放激素（GnRH）激动剂，随后用促卵泡激素（FSH）刺激直至人绒毛膜促性腺激素（hCG）给药日。未治疗组在达到hCG给药日时所需的FSH安瓿数量明显低于治疗组（38.1±18.2对43.9±28.5；p<0.05）。两组在达到的雌二醇峰值水平、hCG给药时的孕酮水平以及回收的卵母细胞数量方面未发现相关性。高催乳素血症未治疗的患者中，形态优良的卵母细胞数量（87.9%对80.4%；p<0.05）、受精率（70.8±28.0对60.8±28.5；p<0.03）以及移植胚胎的平均数量（3.6±1.6对3.2±1.5；p<0.05）明显更高。总之，我们发现短暂性高催乳素血症与ICSI结局呈正相关，尤其是与卵母细胞质量和受精率相关。
