Prolactinomas in infertile women: clinical and endocrine characteristics before and after 24 months of treatment with bromocriptine.
INTRODUCTION Prolactinomas are the most common tumors of the pituitary gland and cause of gonadal dysfunction and infertility. OBJECTIVE To determine the effects of bromcriptin to normalize prolactin, gonadal function more tumor mass and infertility. PATIENTS AND METHODS A prospective clinical study included 30 infertile women with micro-macro prolactinoma. We analyzed clinical parameters, the function of sex hormones, the maximum tumor diameter before and after 24-month therapy with bromocriptine. RESULTS Micro prolactinomas were significantly (66.3% vs. 33.7%, p < 0.001) over-represented in infertile women compared to macro prolactinomas. Galactorrhea / amenorrhea, and infertility are common symptoms of macro-micro prolactinomas. Infertile women with present macro prolactinomas had significantly higher mean values of PRL (1900.3 vs. 7.8, p < 0.001), significantly lower mean FSH (3.4 vs. 4.6, p < 0.001), LH (2.9 vs. 5.2, p < 0.001), luteal progesterone (2.5 vs. 14.8, p < 0.001) and estradiol (E2) (98.2 vs. 180.1, p < 0.001) compared to the control group. Infertile women with micro prolactinomas had significantly higher values of PRL (170.4 vs. 7.8, p < 0.001), significantly lower mean FSH (4.1 vs. 4.6, p < 0.01), LH (3.8 vs. 5.2, p < 0.01) luteal progesterone (2.7 vs. 14.8, p < 0.001) and E2 (120.3 vs. 180.1, p < 0.001) compared to the control group. After 24-month therapy bromocriptine in infertile women with micro-macro prolactinomas followed by a significant decrease in PRL (p < 0.05), a significant reduction of the maximal tumor diameter (p <0.05), a significant increase in FSH, LH, E2 (p < 0.05) compared to baseline values before treatment and a significant reduction in fertility (p < 0.05). CONCLUSION The syndrome amenorrhea/galactorrhea and infertility are the most common symptoms of prolactinomas. Micro prolactinomas are more frequent in women. Bromocriptine is an effective drug in the treatment of hyperprolactinemia with prolactinomas. It effectively normalize prolactin, establishing gonadal function and reduces tumor mass.