CONTEXT: Cabergoline is effective for hyperprolactinemic hypogonadism. However, the rate of cabergoline-induced pregnancy in women with prolactinoma remains unknown. Also unknown is whether cabergoline can control tumor growth and thereby achieve successful pregnancy in patients with macroprolactinomas. METHODS: Eighty-five women with macroprolactinomas (n = 29) or microprolactinomas (n = 56) received prospective, high-dose cabergoline therapy for infertility based on individual prolactin suppression and/or tumor shrinkage. The patients included 31 bromocriptine-resistant, 32 bromocriptine-intolerant, and 22 previously untreated women. Conception was withheld until three regular cycles returned in women with microadenoma and until tumors shrank below 1.0 cm in height in women with macroadenoma. Cabergoline was withdrawn at the fourth gestational week. RESULTS: Cabergoline normalized hyperprolactinemia and recovered the ovulatory cycle in all patients. All adenomas contracted, and 11 macroadenomas and 29 microadenomas disappeared. Eighty patients (94%) conceived 95 pregnancies, two of which were cabergoline-free second pregnancies. The dose of cabergoline at the first pregnancy was 0.25-9 mg/wk overall and 2-9 mg/wk in the resistant patients. Of the 93 pregnancies achieved on cabergoline, 86 resulted in 83 single live births, one stillbirth, and two abortions; the remaining seven were ongoing. All babies were born healthy, without any malformations. No mothers experienced impaired vision or headache suggestive of abnormal tumor reexpansion throughout pregnancy. CONCLUSION: Cabergoline achieved a high pregnancy rate with uneventful outcomes in infertile women with prolactinoma, independent of tumor size and bromocriptine resistance or intolerance. Cabergoline monotherapy could substitute for the conventional combination therapy of pregestational surgery or irradiation plus bromocriptine in macroprolactinomas.
CONTEXT: Cabergoline is effective for hyperprolactinemic hypogonadism. However, the rate of cabergoline-induced pregnancy in women with prolactinoma remains unknown. Also unknown is whether cabergoline can control tumor growth and thereby achieve successful pregnancy in patients with macroprolactinomas. METHODS: Eighty-five women with macroprolactinomas (n = 29) or microprolactinomas (n = 56) received prospective, high-dose cabergoline therapy for infertility based on individual prolactin suppression and/or tumor shrinkage. The patients included 31 bromocriptine-resistant, 32 bromocriptine-intolerant, and 22 previously untreated women. Conception was withheld until three regular cycles returned in women with microadenoma and until tumors shrank below 1.0 cm in height in women with macroadenoma. Cabergoline was withdrawn at the fourth gestational week. RESULTS:Cabergoline normalized hyperprolactinemia and recovered the ovulatory cycle in all patients. All adenomas contracted, and 11 macroadenomas and 29 microadenomas disappeared. Eighty patients (94%) conceived 95 pregnancies, two of which were cabergoline-free second pregnancies. The dose of cabergoline at the first pregnancy was 0.25-9 mg/wk overall and 2-9 mg/wk in the resistant patients. Of the 93 pregnancies achieved on cabergoline, 86 resulted in 83 single live births, one stillbirth, and two abortions; the remaining seven were ongoing. All babies were born healthy, without any malformations. No mothers experienced impaired vision or headache suggestive of abnormal tumor reexpansion throughout pregnancy. CONCLUSION:Cabergoline achieved a high pregnancy rate with uneventful outcomes in infertile women with prolactinoma, independent of tumor size and bromocriptine resistance or intolerance. Cabergoline monotherapy could substitute for the conventional combination therapy of pregestational surgery or irradiation plus bromocriptine in macroprolactinomas.
Authors: B G Sant' Anna; N R C Musolino; M R Gadelha; C Marques; M Castro; P C L Elias; L Vilar; R Lyra; M R A Martins; A R P Quidute; J Abucham; D Nazato; H M Garmes; M L C Fontana; C L Boguszewski; C B Bueno; M A Czepielewski; E S Portes; V S Nunes-Nogueira; A Ribeiro-Oliveira; R P V Francisco; M D Bronstein; A Glezer Journal: Pituitary Date: 2020-04 Impact factor: 4.107
Authors: Rosario Pivonello; Maria Cristina De Martino; Renata S Auriemma; Carlo Alviggi; Ludovica F S Grasso; Alessia Cozzolino; Monica De Leo; Giuseppe De Placido; Annamaria Colao; Gaetano Lombardi Journal: J Endocrinol Invest Date: 2014-01-16 Impact factor: 4.256
Authors: Amy T Wang; Rebecca J Mullan; Melanie A Lane; Ahmad Hazem; Chaithra Prasad; Nicola W Gathaiya; M Mercè Fernández-Balsells; Amy Bagatto; Fernando Coto-Yglesias; Jantey Carey; Tarig A Elraiyah; Patricia J Erwin; Gunjan Y Gandhi; Victor M Montori; Mohammad Hassan Murad Journal: Syst Rev Date: 2012-07-24
Authors: Laura D Ratner; Betina Gonzalez; Petteri Ahtiainen; Noelia P Di Giorgio; Matti Poutanen; Ricardo S Calandra; Ilpo T Huhtaniemi; Susana B Rulli Journal: Endocrinology Date: 2012-11-01 Impact factor: 4.736