Hyperprolactinaemia in male infertility: Clinical case scenarios

Peer review under responsibility of Arab Association of Urology.

Abstract

Objective To explore the evaluation, treatment and impact of hyperprolactinaemia on male infertility and testicular function, as hyperprolactinaemia is commonly detected during the evaluation of infertile men.

Methods A literature search was performed using MEDLINE/PubMed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify all studies exploring hyperprolactinaemia in male infertility.

Results Elevated levels of serum prolactin have a detrimental effect on male reproduction through inhibition of the pulsatile release of gonadotrophins from the anterior pituitary gland, and a direct effect on spermatogenesis. Treatment of confirmed hyperprolactinaemia with dopamine agonists leads to significant improvements in both semen parameters and hormone levels.

Conclusion Hyperprolactinaemia, both directly and indirectly, has a negative effect on sperm production, and its detection and management in men seeking fertility is mandatory.

Abbreviations:

• DA
• Dopamine
• HPG
• Hypothalamic-Pituitary-Gonadal (axis)
• PRISMA
• Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Keywords:

• Prolactin
• Male infertility
• Dopamine agonists
• Testosterone
• Pituitary adenoma

Notes

Peer review under responsibility of Arab Association of Urology.