Hyperprolactinaemia in male infertility: Clinical case scenarios

Arab J Urol. 2017 Nov 16;16(1):44-52. doi: 10.1016/j.aju.2017.10.002. eCollection 2018 Mar.

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.

Keywords: DA, Dopamine; Dopamine agonists; HPG, Hypothalamic-Pituitary-Gonadal (axis); Male infertility; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; Pituitary adenoma; Prolactin; Testosterone.