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Prevalence of Hyperprolactinemia and Clinically Apparent Prolactinomas in Men Undergoing Fertility Evaluation.

Authors
  • Ambulkar, Siddhant S1
  • Darves-Bornoz, Anne L2
  • Fantus, Richard J2
  • Wren, James2
  • Bennett, Nelson E2
  • Halpern, Joshua A2
  • Brannigan, Robert E2
  • 1 Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: [email protected]
  • 2 Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
Type
Published Article
Journal
Urology
Publication Date
Jan 01, 2022
Volume
159
Pages
114–119
Identifiers
DOI: 10.1016/j.urology.2021.03.007
PMID: 33766719
Source
Medline
Language
English
License
Unknown

Abstract

To determine prevalence of hyperprolactinemia and prolactinoma among men presenting for initial fertility evaluation. We performed a retrospective review of men presenting for initial fertility evaluation at a tertiary care, academic health system between 1999 and 2018. Men with measured prolactin levels were analyzed to determine prevalence of hyperprolactinemia and prolactinoma. We compared clinical characteristics of men with and without hyperprolactinemia. Univariable and multivariable analysis were used to determine factors associated with hyperprolactinemia. We assessed effects of hyperprolactinemia and prolactinoma on testosterone levels, semen parameters and pregnancy outcomes after treatment. A total of 3101 men had serum prolactin level measured. 65 (2.1%) had hyperprolactinemia. Patients with hyperprolactinemia had lower testosterone (median 280 ng/dL vs 313 ng/dL, P = 0.038) and lower total motile sperm count (median 7.0 million vs 34.7 million, P = 0.001) compared to men without hyperprolactinemia. 43.1% of men with hyperprolactinemia had oligospermia vs 21.5% of men without hyperprolactinemia (P<0.001). Univariable analysis demonstrated that men with elevated luteinizing hormone (LH) (OR 1.077, P = 0.001) and follicle-stimulating hormone (FSH) (OR 1.032, P = 0.002) were more likely to have hyperprolactinemia. Men with oligospermia were more likely to have hyperprolactinemia (OR 2.334, P = 0.004). On multivariable analysis, neither hormone parameters nor oligospermia were associated with elevated prolactin (P>0.05). Of the 65 men with hyperprolactinemia, 11 (17%) were diagnosed with a prolactinoma, resulting in an overall prevalence of 11 in 3101 (0.35%). The overall prevalence of prolactinoma in our cohort of men undergoing fertility evaluation was 35-fold higher than the prevalence in the general male population. Copyright © 2021. Published by Elsevier Inc.

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