Hyperprolactinemia after laparoscopic ovarian drilling: an unknown phenomenon.
BACKGROUND
The effects of ovarian drilling on the serum levels of gonadotropins and androgens have been studied previously. The aim of this study is to evaluate the effects of ovarian drilling on the serum prolactin levels and its relation to ovulation in women with polycystic ovary syndrome.


METHODS
This is a prospective controlled study. Thirty-six women with PCOS underwent ovarian electrocauterization in university hospitals. Control group consisted of 35 ovulatory women with unexplained infertility. Hormonal assessment performed in early follicular phase of spontaneous or induced cycle before operation in the two groups and repeated one week after operation. Hormonal assay was also performed in the early follicular phase of the first post-operative menstruation, folliculometry and progesterone assay were also performed in the same cycle. Data were analyzed by "repeated measurement design, discriminant analysis, correlation coefficient, and Fisher exact test".


RESULTS
Six to ten weeks after operation the serum mean +/- SD prolactin levels increased from 284.41 +/- 114.32 mIU/ml to 354.06 +/- 204.42 mIU/ml (P = 0.011). The same values for the control group were 277.73 +/- 114.65 to 277.4 +/- 111.4 (P = 0.981) respectively. Approximately 45% of subjects in PCOS group remained anovulatory in spite of decreased level of LH and testosterone. Prolactin level remained elevated in 73.2% of women who did not ovulate 6-10 weeks after the procedure.


CONCLUSIONS
Hyperprolactinemia after ovarian cauterization may be considered as a possible cause of anovulation in women with polycystic ovaries and improved gonadotropin and androgen levels. The cause of hyperprolactinemia is unknown. Hormonal assay particularly PRL in anovulatory patients after ovarian cauterization is recommended.
Parsanezhad
Mohammad E
ME
Division of infertility and GYN endocrinology, Department of Obstetrics and Gynecology, Medical School, Shiraz University of Medical sciences, Shiraz, Iran. parsame@sums.ac.ir
Alborzi
Saeed
S
Zolghadri
Jaleh
J
Parsa-Nezhad
Maryam
M
Keshavarzi
Gholamreza
G
Omrani
Gholamhossein R
GR
Schmidt
Ernst H
EH
D000328:Adult; D000858:Anovulation / Q000209:etiology / Q000601:surgery*; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000175:diagnosis / Q000209:etiology*; D010535:Laparoscopy; D010053:Ovary / Q000601:surgery*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011183:Postoperative Complications; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies
D011388:Prolactin