Hyperprolactinemic recurrent miscarriage and results of randomized bromocriptine treatment trials

Hirahara, Fumiki; Andoh, Noriko; Sawai, Kaori; Hirabuki, Tomoo; Uemura, Tomohiro; Minaguchi, Hiroshi

doi:10.1016/s0015-0282(98)00164-2

Cited by 141 publications

(80 citation statements)

References 21 publications

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“…Nevertheless, there are several facts contradicting this suggestion: Gu (1993) demonstrated that the concentration of serum PRL showed a marked decrease in patients with spontaneous abortion compared to that of women who went to term. Recurrent spontaneous abortion has been associated with abnormal PRL levels (Bussen et al 1999), and miscarriages are often related to significantly elevated PRL serum values (Hirahara et al 1998). Furthermore, higher probability of luteal phase disturbances and infertility in women showing reduced postovulatory serum PRL levels (Kauppila et al 1988) additionally strengthen the concept of PRL involvement in the regulation of the human corpus luteum.…”

Section: Pregnancymentioning

confidence: 99%

Prolactin secretion patterns: basic mechanisms and clinical implications for reproduction

Egli¹,

Leeners²,

Krüger³

2010

Reproduction

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Prolactin (PRL) is one of the most versatile hormones in the mammalian body affecting reproductive, sexual, metabolic, immune, and other functions. It is therefore not surprising that the neural control of PRL secretion is complex, involving the coordinated actions of several hypothalamic nuclei. A plethora of experimental data exists on the hypothalamic control of hormone secretion under various physiological stimuli. There have been even mathematical models and computer studies published, which help to understand the complex hypothalamic-pituitary network. Nevertheless, the putative role of PRL for human reproduction still has to be clarified. Here, we review data on the underlying mechanisms controlling PRL secretion using both experimental and mathematical approaches. These investigations primarily focus on rhythmic secretion in rats during early pregnancy or pseudopregnancy, and they point to the important role of oxytocin as a crucial PRL-releasing factor. Recent data on human studies and their theoretical and clinical implications are reviewed as well. In particular, studies demonstrating a sustained PRL surge after sexual climax in males and females are presented, indicating possible implications for both sexual satiation and reproductive functions. Taking these data together, there is evidence for the hypothesis that the PRL surge induced by sexual activity, together with the altered PRL rhythmic pattern, is important for successful initialization of pregnancy not only in rodents but also possibly in humans. However, further investigations are needed to clarify such a role in humans.

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Section: Pregnancymentioning

confidence: 99%

Prolactin secretion patterns: basic mechanisms and clinical implications for reproduction

Egli¹,

Leeners²,

Krüger³

2010

Reproduction

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“…In a randomized controlled trial by Hirahara et al, they evaluated the effect of isolated hyperprolactinemia in the pathogenesis of recurrent spontaneous abortion. They found that restoration of normal prolactin level with bromocriptine was associated with a significant improvement in the pregnancy outcome, and concluded that appropriate circulating levels of prolactin may play an important role in maintaining early pregnancy, especially in cases of hyperprolactinemic recurrent miscarriage [20]. On the other hand, Li et al found that even low basal serum prolactin level was associated with early pregnancy loss [21].…”

Section: Discussionmentioning

confidence: 99%

Recurrent Pregnancy Loss in Patients with Polycystic Ovary Syndrome: A Case Control Study

Ashaq¹,

Mazer²,

Qahtani³

2017

OJOG

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Objectives: To identify different biophysical and hormonal factors that could contribute to recurrent pregnancy loss in Saudi women who have been diagnosed with polycystic ovary syndrome. Study Design: Case-control study. Settings: Infertility clinic in Dammam Maternity and Children Hospital. Cases: PCOS patients with recurrent pregnancy loss. Controls: PCOS patients without recurrent pregnancy loss. Results: The prevalence of recurrent abortion in PCOS patients was 31%. There was no significant difference between the cases and the controls in the age, 33.1 years versus 31.9 years, BMI, 31.4 kg/m 2 versus 31.6 kg/m 2 respectively. There was no significant difference in the successful pregnancies outcome in cases and controls, term deliveries 84% versus 90%, preterm deliveries 10% versus 5%, twin pregnancy 6% versus 5% respectively. There was no significant difference in the hormonal profile (prolactin, LH, FSH, LH/FSH ratio, TSH, progesterone, testosterone) between cases and controls. Serum estradiol level was significantly lower in the cases compared to the controls, 55.5 pg/mL versus 83.9 pg/mL respectively (p < 0.01). Conclusion: PCOS patients with recurrent abortions had no significant increase in the age, BMI, preterm pregnancy, multiple gestation and ectopic pregnancy. The hormonal profile (prolactin, LH, FSH, LH/FSH ratio, TSH, progesterone, testosterone) was comparable between the cases and the controls, except for serum estradiol level, which was significantly lower in PCOS patients with recurrent abortions.

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“…A randomized control trial of 64 hyperprolactinaemic women with RPL treated with bromocriptine was associated with a higher rate of successful pregnancy, and PRL levels were significantly higher in women that miscarried. 24 Treatment resulted in an 85.7% live birth rate, whereas the untreated cohort had a 52.4% live birth outcome. Bromocriptine was given before conception and continued until the end of the 9th week of gestation in the group of patients in whom the serum PRL levels were normalized.…”

Section: Hyperprolactinaemiamentioning

confidence: 96%

Hormonal causes of recurrent pregnancy loss (RPL)

Pluchino¹,

Drakopoulos²,

Wenger³

et al. 2014

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Endocrine disorders play a major role in approximately 8% to 12% of recurrent pregnancy loss (rPL). Indeed, the local hormonal milieu is crucial in both embryo attachment and early pregnancy. Endocrine abnormalities, including thyroid disorders, luteal phase defects, polycystic ovary syndrome, hyperprolactinaemia and diabetes have to be evaluated in any case of rPL. Moreover, elevated androgen levels and some endocrinological aspects of endometriosis are also factors contributing to rPL. In the present article, we review the significance of endocrine disease on rPL.

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Hyperprolactinemic recurrent miscarriage and results of randomized bromocriptine treatment trials

Cited by 141 publications

References 21 publications

Prolactin secretion patterns: basic mechanisms and clinical implications for reproduction

Prolactin secretion patterns: basic mechanisms and clinical implications for reproduction

Recurrent Pregnancy Loss in Patients with Polycystic Ovary Syndrome: A Case Control Study

Hormonal causes of recurrent pregnancy loss (RPL)

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