- The role of hyperprolactinaemia in the genesis of stressQinduced infertility and the possibility of its correction
The role of hyperprolactinaemia in the genesis of stressQinduced infertility and the possibility of its correction
HEALTH OF WOMAN. 2017.6(122):31–39
Tatarchuk T. F., Kosei N. V., Reheda S. I., Iarotska N. V., Gorokhova G. O.
SI «Institute of Pediatrics, Obstetrics and Gynecology NAMS of Ukraine», Kiev
An evaluation of the effectiveness of primary stress-induced infertility treatment was carried out using complex therapy aimed at correcting the psychoemotional state and secondary hyperprolactinemia in 72 patients aged 24 to 40 with reproductive plans (38 women in the main group and 34 in the comparison group). 30 healthy – the control group. Before treatment, studies of hormonal homeostasis showed a decrease in the average level of pituitary hormones, rather low average concentrations of estradiol and progesterone, a moderately elevated level of prolactin and reduced endometrial thickness in all patients. An increased level of personal and reactive anxiety was also noted in most women. In addition to anti-stress therapy with the use of phenibut and mebekar, the patients of the main group received mild dopaminomimetic Cyclodinon, which promotes oppression of prolactin secretion and normalization of the function of the hypothalamic-pituitary-ovarian system. Patients of the comparison group received only anti-stress therapy. Already 3 months after the start of complex anti-stress therapy in both groups, the level of reactive anxiety decreased, and to a lesser extent – personal anxiety. The dynamics of restoration of hormonal homeostasis in the groups was significantly different. Thus, a more significant decrease in the average concentration of prolactin and an increase in the synthesis of follicle-stimulating, luteinizing hormones, estradiol and progesterone in the blood serum was noted in the main group. In her, an increase in the thickness of the endometrium was noted. In the comparison group, where only anti-stress therapy was used, only a trend was observed without complete normalization. Within three years after the course of treatment, 32 (94.11%) patients of the main group had pregnancy, and only 17 (50%) had a comparison group. From the results of the study, it can be concluded that the combination of antistress and dopaminergic therapy is highly effective. Therefore, it is possible to recommend the prescription of dopaminergic phytopreparations, in particular Cyclodinon, against the background of antistress therapy for patients with stress induced infertility in order to correct psychosomatic disorders and increase the clinical frequency of pregnancy.
Key words: stress, infertility, anxiety, Cyclodynon®.
1. Parashchuk YuS, Kalinovska OI, Hryshchenko MH, Parashchuk VIu. 2014. Bezplidnist u shliubi: navch. posibnyk. Kharkiv, KhNMU:124.
2. Louis GM, Lum KJ, Sundaram R et al. 2011. Stress reduces conception probabilities across the fertile window: evidence in support of relaxation. Fertil Steril 95:2184–9. https://doi.org/10.1016/j.fertnstert.2010.06.078; PMid:20688324 PMCid:PMC2975045
3. Piekarski DJ, Zhao S, Jennings KJ et al. 2013. Gonadotropin-inhibitory hormone reduces sexual motivation but not lordosis behavior in female Syrian hamsters (Mesocricetus auratus). Hormones and Behavior 64:501–10. https://doi.org/10.1016/j.yhbeh.2013.06.006; PMid:23827890 PMCid:PMC3955721
4. Sanders R. 2015, Jan 12. «Blocking hormone could eliminate stress-induced infertility». Berkeley news online. Available from: http:// news. berkeley. edu/ 2015/01/12/blocking-hormone-couldeliminate-stress-induced-infertility/, last accessed Nov 15, 2016.
5. Sato Y, Suzuki N, Horita H et al. 1996. Effects of long-term psychological stress on sexual behavior and brain catecholamine levels. Journal of Andrology 17:83–90. PMid:8723430
6. Son YL, Ubuka T, Millar RP et al. 2012. Gonadotropin-inhibitory hormone inhibits GnRH-induced gonadotropin subunit gene transcriptions by inhibiting AC/cAMP/PKA-dependent ERK Pathway in L[beta]T2 cells. Endocrinology 153:2332–43. https://doi.org/10.1210/en.2011-1904; PMid:22374973
7. Anna C Geraghty, Sandra E Muroy, Sheng Zhao et al. Knockdown of hypothalamic RFRP3 prevents chronic stress-induced infertility and embryo resorption. University of California. Berkeley, United States. Canadian Institute for Advanced Research, Canada.
8. Batarshev AV. 2005. Bazovyie psihologicheskie svoystva i samoopredelenie lichnosti: Prakticheskoe rukovodstvo po psihologicheskoy diagnostike. SPb, Izdatelstvo «Rech»:44–49.
9. Diagnostiki emotsionalno-nravstvennogo razvitiya. Red. i sost. IB Dermanova. SPb, Izdatelstvo «Rech». 2002:124–126.
10. Praktikum po psihologii sostoyaniy: Uchebnoe posobie. Pod red. prof. OA Prohorova. SPb, Izdatelstvo «Rech». 2004:121–122.
11. Sele G. 1960. Ocherki ob adaptatsionnom sindrome. M, Medgiz.
12. Morozov VN, Hadartsev AA. 2010. K sovremennoy traktovke mehanizmov stressa 1. VNMT.
13. Paton A, Harley R, Harvey T. 2000. Editorial. Vitex: A Newsletter for Lamiaceae & Verbenaceae Research 1, available from: http: //www. kew. org/ data/ vitex/jan00.pdf, last accessed Nov 15, 2016.
14. Merz PG, Gorkow C, Schrodter A et al. 1996. «The effects of a special Agnus castus extract (BP1095E1) on prolactin secretion in healthy male subjects». Exp Clin Endocrinol Diabetes 104;6:447–53. https://doi.org/10.1055/s-0029-1211483
15. Berger D, Schaffner W, Schrader E et al. 2000. Efficacy of Vitex agnus castus L. extract Ze 440 in patients with premenstrual syndrome (PMS). Arch Gynecol Obstet 264.3:150–3. https://doi.org/10.1007/s004040000123; PMid:11129515
16. Schellenberg R. 2001. Treatment for the premenstrual syndrome with agnus castus fruit extract: prospective, randomised, placebo controlled study. British Medical Journal 322(7279):134–7. https://doi.org/10.1136/bmj.322.7279.134; PMid:11159568 PMCid:PMC26589
17. Milewicz A, Gejdel E, Sworen H et al. 1993. Vitex agnus castus extract in the treatment of luteal phase defects due to latent hyperprolactinemia. Results of a randomized placebo-controlled double-blind study. Arzneimittelforschung 43(7):752–6. PMid:8369008
18. Dmitrieva TB, Drozdov AZ, Kogan BM. 2004. Osnovnyie nespetsificheskie sistemyi, adaptiruyuschie organizm k ostromu i hronicheskomu stressu. Psihiatriya chrezvyichaynyih situatsiy. Rukovodstvo. M:8–41.
19. Balabolkin MI. 1989. Endokrinologiya. M, Meditsina:416.
20. Vaks VV. 2001. Giperprolaktinemiya: prichinyi, klinika, diagnostika i lechenie. Consilium medicum. 3;11:516–525.
21. Dzeranova LK, Tabeeva KI, Goncharov NP i dr. 2005. Makroprolaktinemiya. Problemyi reproduktsii 11(2):60–65.
22. Colao A, di Sarno A, Pivonello R et al. 2002. Dopamine receptor agonists for treating prolactinomas. Expert Opin Investig Drugs 11(6):787–800. https://doi.org/10.1517/135437184.108.40.2067; PMid:12036422
23. Delitala G. 1992. Hyperprolactinaemia: causes, biochemical diagnosis and tests of prolactin secretion. Clinical Endocrinology ed. by A. Grossman. Oxford :123–47.
24. Molitch ME. 2001. Disorders of prolactin secretion. Endocrinol Metab Clin North Am 30(3):585–610. https://doi.org/10.1016/S0889-8529(05)70203-6
25. Olukoga AO. 2002. Macroprolactinaemia is clinically important. J Clin Endocrinol Metab 87(10):4833–4. https://doi.org/10.1210/jc.2002-020936; PMid:12364483
26. Schlechte JA. 2002. Editoral: the macroprolactin problem. J Clin Endocrinol Metab 87(12):5408–9. https://doi.org/10.1210/jc.2002-021617; PMid:12466326
27. Toldy E, Zoltan L, Szabolcs I. 2003. Hyperprolactinemia. Endocrine 22(3):267–73.
28. Akmaev IG. 2003. Neyroimmunoendokrinologiya: istoki i perspektivyi razvitiya. Usp. fiziol. nauk 34;4:4–15.
29. Shalyapina VG, Rakitskaya VV. 2003. Reaktivnost gipofizarno-adrenokortikalnoy sistemyi na stress u kryis s aktivnoy i passivnoy strategiyami povedeniya. Ros. fiziol. zhurn. im. I.M. Sechenova 89;5:585–590.
30. Aguilera G, Kiss A, Liu Y, Kamitakahara A. 2007. Stress 10(2):153–61. https://doi.org/10.1080/10253890701391192; PMid:17514584
31. Ben-Jonathan N, Liby K, McFarland M, Zinger M. 2002. Prolactin as an autocrine/paracrine growth factor in human cancer. Trends Endocrinol Metab 13(6):245–50. https://doi.org/10.1016/S1043-2760(02)00603-3
32. Hinuma S, Shintani Y, Fukusumi S et al. 2000. New neuropeptides containing carboxy-terminal RFamide and their receptor in mammals. Nat Cell Biol 2(10):703–8. https://doi.org/10.1038/35036326; PMid:11025660
33. Tsutsui K, Saigoh E, Ukena K et al. 2000. A novel avian hypothalamic peptide inhibiting gonadotropin release. Biochem Biophys Res Commun 275(2):661–7. https://doi.org/10.1006/bbrc.2000.3350; PMid:10964719
34. Yin H, Ukena K, Ubuka T, Tsutsui K. 2005. A novel G protein-coupled receptor for gonadotropininhibitory hormone in the Japanese quail (Coturnix japonica): identification, expression and binding activity. J Endocrinol 184(1):257–66. https://doi.org/10.1677/joe.1.05926; PMid:15642802
35. Serov VN, Zvenigorodskiy IN. 2003. Diagnostika ginekologicheskih zabolevaniy s kursom patologicheskoy anatomii. M, BINOM. Laboratoriya znaniy: 139.