Ionescu O, Vulpoi C, Ungureanu M C, Ionescu D, Zbranca E
Facultatea de Medicină, Clinica Endocrinologică, Universitatea de Medicină şi Farmacie Gr. T. Popa Iaşi.
Rev Med Chir Soc Med Nat Iasi. 2001 Oct-Dec;105(4):806-9.
Prolactinoma is a frequent endocrine cause of infertility in both man and women. The aim of this study was to evaluate female fertility in association with hyperprolactinemia. The study is a retrospective one, based on the cases monitored in the Endocrinology Department of Iaşi. From the 113 cases of prolactinoma in women we have selected 83 women aged between 18-45 years (fertile age). The diagnosis was suspected on clinical bases: endocrine (amenorrhea-galactorrhea, associated or isolated, spaniomenorrhea, infertility), and tumoral (headache, visual disturbances) syndromes and confirmed by biological (PRL dosage) and morphological (pituitary CT) tests. We classified the found associations between prolactinoma and fertility in: no correlation (previous pregnancies with no desire for another child--76 patients = 75.2%); prolactinoma diagnosed immediately after a pregnancy by persistency of galactorrhea, lack of menses reapparition, headache (16 cases = 15.8%); prolactinoma diagnosed before pregnancy, which was obtained thanks to the hyperprolactinemia treatment (9 patients = 8.9%). All 9 patients of the last group were in remission at the moment of pregnancy apparition and had a normal pregnancy, giving birth to normal children. Infertility associated with prolactinoma is reversible with treatment. Lowering of prolactin levels to normal is often necessary to permit ovulation. Bromocriptine used by pregnant women appears to be safe for the developing fetus, at least in our study where the treatment was interrupted in most cases in the first trimester of pregnancy.
泌乳素瘤是男性和女性不育常见的内分泌原因。本研究旨在评估与高泌乳素血症相关的女性生育能力。该研究是一项回顾性研究，基于在雅西内分泌科监测的病例。在113例女性泌乳素瘤病例中，我们选取了83名年龄在18 - 45岁（生育年龄）的女性。诊断基于临床依据怀疑：内分泌（闭经 - 溢乳，相关或孤立，月经稀发，不育）和肿瘤（头痛，视觉障碍）综合征，并通过生物学（泌乳素测定）和形态学（垂体CT）检查确诊。我们将泌乳素瘤与生育能力之间发现的关联分类为：无相关性（既往有妊娠且不想要另一个孩子 - 76例患者 = 75.2%）；妊娠后因溢乳持续、月经未复现、头痛立即诊断出泌乳素瘤（16例 = 15.8%）；妊娠前诊断出泌乳素瘤，这得益于高泌乳素血症治疗（9例患者 = 8.9%）。最后一组的所有9例患者在妊娠出现时病情缓解，妊娠正常，产下正常婴儿。与泌乳素瘤相关的不育通过治疗是可逆的。通常需要将泌乳素水平降至正常以促进排卵。孕妇使用溴隐亭对发育中的胎儿似乎是安全的，至少在我们的研究中，大多数情况下在妊娠早期中断了治疗。
