Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
Endocr Pract. 2010 Jul-Aug;16(4):669-72. doi: 10.4158/EP10026.CR.
To describe the achievement of fertility in an infertile man with a resistant macroprolactinoma by using high-dose bromocriptine and a combination of human chorionic gonadotropin (hCG) and an aromatase inhibitor.
We present historical features and results of clinical, laboratory, and imaging evaluation in a man with secondary infertility attributable to a resistant macroprolactinoma.
We report a case of macroprolactinoma in a 36-year-old infertile man who failed to attain a normal serum testosterone level and fertility with use of either bromocriptine or cabergoline treatment. Testosterone replacement or hCG therapy in this patient resulted in an increase in serum prolactin levels, which declined after discontinuation of this therapy. The combination of high doses of bromocriptine, hCG, and an aromatase inhibitor facilitated near-normalization of serum prolactin levels, shrinkage of the macroprolactinoma, recovery of serum testosterone levels, sexual function, and sperm count, and achievement of fertility.
An aromatase inhibitor may facilitate successful testosterone replacement therapy in male patients with prolactinoma.
描述一名患有耐药性大泌乳素瘤的不育男性通过使用高剂量溴隐亭和人绒毛膜促性腺激素（hCG）联合芳香化酶抑制剂实现生育能力的情况。
我们介绍了一名继发于耐药性大泌乳素瘤的男性不育患者的临床、实验室和影像学评估的历史特征和结果。
我们报告了一例 36 岁男性的大泌乳素瘤病例，该患者使用溴隐亭或卡麦角林治疗未能达到正常的血清睾酮水平和生育能力。该患者的睾酮替代或 hCG 治疗导致血清泌乳素水平升高，停药后该水平下降。高剂量溴隐亭、hCG 和芳香化酶抑制剂的联合使用促进了血清泌乳素水平的接近正常化，大泌乳素瘤的缩小，血清睾酮水平、性功能和精子计数的恢复，以及生育能力的实现。
芳香化酶抑制剂可能有助于患有泌乳素瘤的男性患者成功进行睾酮替代治疗。
