[Serum prolactin levels during sleep and in metoclopramide stimulation in normoprolactinemic anovulation and ovulation induction with bromocriptine].

Diurnal and nocturnal serum prolactin (PRL) levels were determined in 37 normoprolactinemic anovulatory (nPRL-Anov) patients and 6 normal cycling women each in the early follicular phase (EFP) and the luteal phase (LP). PRL responsiveness to metoclopramide (MCP) was assessed. The nPRL-Anov patients received 5mg/day bromocriptine (CB-154) for 2 months and ovulation was investigated. To the CB-154 non-responders was added 150mg/day clomiphene (CL) for 5 days. The nPRL-Anov patients were classified into 3 groups; i.e. I: those who ovulated with CB-154 (n = 14), II: those who ovulated with CB-154 + CL (n = 6), and III: those who failed to ovulate (n = 10). Nocturnal serum PRL levels in I (42.0 +/- 26.2ng/ml; M +/- SD) were significantly higher than those in EFP, II and III (p less than 0.05). Eleven (78.6%) of I had nocturnal PRL levels higher than 25ng/ml. The peak PRL values at MCP provocation were significantly higher in I (213.3 +/- 89.1ng/ml) than in EFP, II and III (p less than 0.01). Thirteen (92.9%) of I had peak PRL values more than 150ng/ml. The peak PRL values and nocturnal PRL levels correlated. There were some exhibiting nocturnal or latent hyperprolactinemia, who responded effectively to CB-154, among nPRL-Anov patients. A MCP provocation test could be used in prediction of the efficacy of CB-154 treatment when applied to nPRL-Anov patients.