What is the relationship between high prolactin and infertility? When prolactin continues to rise, luteal insufficiency – irregular ovulation – complete absence of ovulation will occur, resulting in amenorrhea. High blood prolactin causes the ovary to lose its normal response to gonadotropins, resulting in poor follicular development, a significant reduction in the number of granulosa cells after ovulation, low secretion of progesterone, luteal insufficiency, resulting in infertility or recurrent miscarriage. Because the release of FSH and LH is inhibited, LH is unable to form a preovulatory peak, which leads to the sign of follicular luteinization without rupture. Hyperprolactinic conditions, with insufficient estrogen and progesterone secretion and no significant LH peak present, cause the endometrium to lack the typical A, B, and C cyclic changes, and the endometrium to be thin and often exhibit an inhomogeneous B-type endometrium in the preovulatory phase. Endometrial dysplasia and asynchrony is another cause of infertility due to hyperprolactinemia.