https://imcjms.com/public Ibrahim Medical College Journal of Medical Science https://imcjms.com/public/registration/journal_full_text/246 Sat, 08 Jul 2017 15:34:22 +0000 Abstract Methods: The study involved a total of 100 women of which 50 had primary (Group A) and another 50 had secondary (Group B) infertility. Fifty fertile age-matched women were included as control (Group C). All the study participants were selected from women attending the infertility unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Serum prolactin, FSH and LH hormones were measured by radioimmunoassay with blood collected on the 2nd day of menstrual cycle. IMC J Med Sci 2018; 12(1): 01-05. DOI: https://doi.org/10.3329/imcjms.v12i1.35169 Address for Correspondence:Dr. Shamima Bari, Assistant Professor, Department of Physiology, Ibrahim Medical College, 122 Kazi Nazrul Islam Avenue, Shahbag, Dhaka. E-mail: shamima.bari@yahoo.com Introduction Hormonal disorders of female reproductive system occur due to aberrant dysfunction of hypo-thalamic-pituitary-ovarian axis and are relatively common disorders leading to infertility. The increased or decreased levels of prolactin, FSH and LH hormones may cause infertility [8-10]. High level of prolactin may cause infertility affecting FSH and gonadrotropin releasing hormone (GnRH) [11]. High prolactin level inhibits GnRH and follicle stimulating hormone leading to infertility [12-16].   This cross sectional study was carried out in the department of Physiology, Dhaka Medical College, Dhaka from July 2010 to June 2011 and the protocol was approved by Ethical Review Committee of Dhaka Medical College.            Infertile women having husbands with normal semen analysis results and normal genitalia, uterus and adnexa were included. Women with tubal factor, congenital anomaly of urogenital tract and any obvious organic lesion or pelvic inflammatory diseases, and lactating women were excluded from this study. The purpose and benefits of the study were explained to each participant and informed written consent was taken from each of them. A detailed personal, medical, family, socio-economic and drug history were recorded in a predesigned questionnaire. Biochemical parameters and collection of blood: Aseptically 5 milliliter of blood was collected from medial cubital vein from each participant in the 2nd day of menstrual cycle. Blood was allowed to clot for 30-60 minutes at room temperature and then centrifuged at 3000 rpm for 5-10 minutes and serum was separated and preserved at -20°C for estimation of serum prolactin, FSH and LH. Prolactin, FSH and LH were measured by radioimmunoassay at the Centre for Nuclear Medicine and Ultrasound, Dhaka Medical College.The analysis was done within 2 weeks of blood collection. The normal range for prolactin, FSH and LH were 2 -25 ng/dl, 3.1-7.9 IU/L and 1.9 -12.5 IU/L respectively.     Out of 50 cases of primary infertility, 84% had normal and 16% had high prolactin level (>25 ng/dl). The rate was 86% and 14% respectively in secondary infertility cases. Only 2 cases (4%) with normal fertility had high prolactin level. In women with primary sterility, the serum FSH and LH levels were lower than the normal levels in 54% and 10% cases respectively while in secondary sterility the levels were low in 30% and 28% cases respectively. Compared to women with secondary sterility, significantly (p<0.05%) higher number of cases with primary sterility (30% vs. 54%) had FSH level below the normal range (Table-3). On the other hand, compared to primary sterility group significantly higher number of cases with secondary sterility (10% vs 28%) had LH level below the normal range.     Hormone levels in women with infertility have been evaluated by many researchers. High prolactin level has been reported as the cause of female infertility [12,13]. In the present study, the overall mean serum prolactin level was significantly higher in infertile women than that of control fertile women. However, only 14-16% women with primary and secondary infertility had prolactinemia above the recommended normal range. Similar observation was also reported by other investigators from different countries [16,19-24]. In the present study, the observation of high prolactinemia in 30% women with primary and secondary infertility in our study is in agreement with other studies elsewhere [15,25-29]. High prolactinemia is the commonest biochemical abnormality observed in infertility [28]. Furthermore, prolactin may affect the ovaries by altering ovarian progesterone secretion and estrogen synthesis leading to infertility [27,28]. Women with high level of prolactin may ovulate regularly but may not produce enough progesterone during luteal phase after ovulation. Deficiency of progesterone produced after ovulation, may hamper embryo implantation in a uterine lining [30,31]. Therefore, the present study has demonstrated that a significant number of women with primary and secondary infertility have altered prolactin, FSH and LH levels compared to fertile women.Acknowledgement   1.   Momtaz H, Flora MS, Shirin S. Factors associated with secondary infertility. Ibrahim Med Coll J. 2011; 5(1): 17-2. 3.   Safarinejad R. Infertility among couples in a population based study in Iran: prevalence and associated risk factors. Int J Andrology.2007; 31: 303-314. 5.   Farely TMM, Baisey EM. The prevalence of an etiology of infertility. 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