Parra A, Crespo G, Coria I, Espinosa de los Monteros A
Department of Endocrinology, Instituto Nacional de Perinatologia, Mexico City, Mexico.
Int J Fertil Menopausal Stud. 1995 Mar-Apr;40(2):96-101.
OBJECTIVE -- To determine if intermittent oral bromocriptine administration could be a useful therapeutic alternative in infertile hyperprolactinemic women. DESIGN -- Open, randomized and prospective study. SETTING -- Outpatient infertility clinic of a third-level medical institution. PATIENTS -- Fourteen low-income women, 23 to 36 years of age with anovulatory infertility (1-13 years in duration) secondary to hyperprolactinemia (>35 ng/mL). Endocrine profile ruled out anovulation of other origin. INTERVENTIONS -- After a control period of 30 days, seven women (group 1) received daily oral bromocriptine (2.5-10.0 mg/day) continuously during two consecutive 30-day periods (T-1 and T-2), and seven women (group 2) received oral bromocriptine only from day 1 to 15 of each 30-day period of treatment. Morning blood samples were drawn similarly during the three periods on days 6 to 8, 13 to 15, and 21 to 23. MAIN OUTCOME MEASURES -- FSH, LH, and prolactin were determined in all samples, estradiol only in samples of days 6 to 8 and 13 to 15, and progesterone exclusively between days 21 and 23.
Mean serum prolactin levels during the control period were similarly elevated in groups 1 and 2. A marked decrease occurred during period T-1 (P < .004) and further during period T-2 (P < .05) in both groups, but at no time were significant intergroup differences documented. During the control period all women had a serum progesterone < 3.0 ng/mL (<9.54 nmol/L); during period T-2 it was > or = 3.0 ng/mL in three and five women of groups 1 and 2, respectively. Over the following 10 months of treatment, two and three normal pregnancies and deliveries ensued in groups 1 and 2, respectively. CONCLUSION -- The intermittent use of oral bromocriptine may indeed be a useful therapeutic approach in treating infertile hyperprolactinemic women.
目的——确定间歇性口服溴隐亭对高泌乳素血症不孕女性是否为一种有效的治疗选择。设计——开放性、随机前瞻性研究。地点——三级医疗机构的门诊不孕诊所。患者——14名低收入女性，年龄23至36岁，因高泌乳素血症（>35 ng/mL）继发无排卵性不孕（病程1至13年）。内分泌检查排除其他原因引起的无排卵。干预措施——在30天的对照期后，7名女性（第1组）在连续两个30天周期（T - 1和T - 2）中每日持续口服溴隐亭（2.5 - 10.0 mg/天），7名女性（第2组）在每个30天治疗周期的第1天至15天口服溴隐亭。在三个时期的第6至8天、13至15天和21至23天早晨相似时间采集血样。主要观察指标——测定所有样本中的促卵泡生成素（FSH）、促黄体生成素（LH）和泌乳素，仅在第6至8天和13至15天的样本中测定雌二醇，仅在第21至23天之间测定孕酮。
第1组和第2组在对照期的平均血清泌乳素水平同样升高。两组在T - 1期（P <.004）和进一步在T - 2期（P <.05）均出现显著下降，但两组间在任何时候均未记录到显著差异。对照期所有女性血清孕酮<3.0 ng/mL（<9.54 nmol/L）；在T - 2期，第1组和第2组分别有3名和5名女性血清孕酮≥3.0 ng/mL。在接下来10个月的治疗中，第1组和第2组分别有2例和3例正常妊娠并分娩。结论——间歇性口服溴隐亭确实可能是治疗高泌乳素血症不孕女性的一种有效治疗方法。
