Pregnancy and the Hyperprolactinemic Woman

HYPERPROLACTINEMIA has been found to be the cause of infertility in about one third of women presenting with this problem.^{1 2 3} Hyperprolactinemia may impair the hypothalamic–pituitary–ovarian axis at several levels, with the primary site of inhibition probably at the hypothalamic level.⁴,⁵ Studies of gonadotropin secretion in hyperprolactinemic subjects sometimes show decreased pulsatile secretion,⁶,⁷ which reverts to normal in most women when hyperprolactinemia is corrected by bromocriptine treatment.⁶,⁷ Pituitary responsiveness to gonadotropin-releasing hormone is normal in such women, however, and a normal pattern of gonadotropin pulsatile secretion is restored with small, repetitive doses of the hormone.⁷ Such data support the concept that.