Pregnancy in hyperprolactinemic infertile women treated with vaginal bromocriptine: Report of two cases and review of the literature

Vaginal bromocriptine has proven safe and effective in treating hyperprolac tinemic women. However, there has been no long-term clinical assessment reg arding the influence of daily vaginal bromocriptine administration on the a bility to conceive, This article presents two cases of successful pregnancy resulting from this alternative treatment, An infertile woman with an empt y sella and hyperprolactinemia was treated with vaginal bromocriptine becau se of intolerance to oral administration. Prolactin levels were quickly nor malized and no side effects occurred. Repeated postcoital tests during trea tment proved normal. Twelve months later, the patient conceived. The therap y was discontinued during pregnancy, without complications. Although bromoc riptine treatment was not resumed after delivery, postpartum prolactin leve ls were lower than before treatment and magnetic resonance imaging revealed an unchanged empty sella, Another patient with infertility and pituitary m icroadenoma with intolerance to oral dopaminergic agonists received the sam e treatment. Prolactin quickly fell to within the normal range. Vaginal bro mocriptine was well tolerated and postcoital test results were not impaired . Tumor regression occurred and 10 months later the patient conceived. Desp ite bromocriptine withdrawal, no significant complications occurred during pregnancy. It can therefore be concluded that a couple's fertility does not appear to be significantly affected by the persistent local presence of br omocriptine. Copyright (C) 2001 S. Karger AG, Baser.