To assess the relationship between in vitro embryo quality and high prolactin levels during sperm transplantation treatment

Abstract

Background: Prolactin is a hormone secreted during lactation in healthy women and plays a significant role in physiological functions, particularly in promoting the proliferation and differentiation of mammary glands. Clinical manifestations of hyperprolactinemia are characterized by gender-specific presentations, particularly in women, resulting in conditions such as infertility, menstrual cycle irregularities, oligomenorrhea, hypomenorrhea, hypermenorrhea, and polymenorrhea. Research has established that hyperprolactinemia disrupts critical reproductive processes, including oocyte maturation, early corpus luteum formation, blastocyst attachment to the uterine wall, and synchrony between the embryo and endometrium, thereby leading to infertility. These pathological mechanisms are related to decreased synthesis of kisspeptin in KISS-1 neurons in response to elevated prolactin levels, which inhibit the secretion of gonadotropin-releasing hormone (GnRH) through a negative feedback loop and subsequently reduce the release of gonadotropins (LH, FSH). For instance, women experiencing infertility with hyperprolactinemia show decreased quality parameters for both oocytes and embryos, alongside a prevalence of implantation failure. Aim: To compare prolactin hormone levels and in vitro embryo development in infertile women and evaluate embryos from in vitro fertilization treatment. Materials and Methods: This retrospective study included women aged 25 to 35 years who underwent in vitro fertilization (IVF) treatment at the RMC IVF Center between 2019 and 2023. A case-control model was established, which included 30 participants with hyperprolactinemia in the case group and 78 age-matched participants from the control group diagnosed with infertility caused by fallopian tubes (N97.1). Results: Evaluating Implantation success (bHCG>0.5 IU/ml) rate, successful implantation occurred in 63.8% (n=30) of the case group and 76.0% (n=92) of the control group, revealing that hyperprolactinemia was associated with a 1.80-fold reduction in pregnancy success rates (OR=1.80 p<0.05). Conclusion: Elevated serum prolactin levels in infertile women increase the risk of poor embryo division and failure to implant in the uterine wall during the insemination process.