DIAGNOSIS AND TREATMENT OF HYPERPROLACTINEMIA SYNDROME IN INFERTILITY IN WOMEN

Azizova M. E., Mammedli G. H., Hajizade G. G., Babaeva G. I., Sirajli U. M.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Abstract. Goal. To evaluate the effectiveness of Dostinex in the treatment of infertile women with hyperprolactinemia. Methods. We examined 50 women of reproductive age with functional hyperprolactinemia, suffering from endocrine infertility and with completely excluded male factor of infertility. Inclusion criteria: female age ≥19 years and <42 years; history of infertility over one year. The control group consisted of 30 women with a history of spontaneous pregnancies, who did not have infertility, reproductive losses, or increased prolactin levels. All patients were assessed for total prolactin by Macro ELISA using the Access 2 laboratory system. Hyperprolactinemia was diagnosed with prolactin levels above 25 ng/ml. When diagnosed with hyperprolactinemia, Dostinex was prescribed. The dose and duration of the drug were determined individually, taking into account the initial level of prolactin. The criteria for discontinuation of the drug were reduction/normalization of prolactin levels in the blood, cessation of galactorrhea, normalization of the menstrual cycle, and restoration of ovulation. Results. In hyperprolactinemia, regardless of the cause, the key link is an increase in prolactin levels. The basal level of prolactin in the blood plasma of patients with functional hyperprolactinemia varied widely – from 37.6 ng/ ml to 100.5 ng/ml. The average value was 63.6±3.49 ng/ml. The average prolactin level in women in the control group was 20.8±1.29 ng/ml (p<0.001). In order to reduce the level of prolactin, all patients were prescribed the drug Dostinex. Taking into account the individual initial level of prolactin, the average therapeutic dose of the drug was determined, which was 0.35±0.1 mg per week. To obtain a clinical effect, 26 (52.0%) patients had enough 0.25 mg, and 24 (48.0%) - 0.5 mg of the drug per week. In patients treated with Dostinex, changes in the dynamics of treatment related to the following laboratory parameters. The PRL level decreased 2.3 times (28.2±0.76 ng/ml vs 63.6±3.49 ng/ml before treatment; p<0.001). The study of the effectiveness of therapy with Dostinex after 1 month of therapy showed that the level of prolactin in the observed patients was within the laboratory norms in 43 (86.0%) patients. In 7 (14.0%) patients whose prolactin values did not reach laboratory standards after one month, it returned to normal after 3 months. Conclusion. Drug therapy of hyperprolactinemia with Dostinex allows to achieve a normal level of prolactin, normalize menstrual function, and eliminate galactorrhea in all observed patients.

infertility, prolactin, hyperprolactinemia, treatment, Dostinex.

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«Bulletin of problems biology and medicine» Issue 1 (159), 2021 year, 15-18 pages, index UDK 618.3:616-055. 2-08

10.29254/2077-4214-2021-1-159-15-18