Bromocriptine versus progesterone therapy for infertility related to luteal phase defects in hyperprolactinemic...

Several anecdotal reports suggested an association of luteal phase defects (LPD) and hyperprolactinemia. Some physicians treat LPD with ovulation-inducing drugs, whereas others recommend progesterone support of the luteal phase. A study was thus initiated to evaluate in cases of LPD associated with hyperprolactinemia which therapy would be more efficacious--bromocriptine or progesterone (P). LPD was divided into two types based on follicle dynamic studies: (1) LPD associated with immature follicles and (2) pure LPD when the follicle was mature. The objective was to determine if P or bromocriptine would be more effective depending on the type of LPD. Randomized therapy with either bromocriptine (BCT) or progesterone vaginal suppositories (PVS) was given to 60 patients with pure LPD (established by endometrial biopsy in the late luteal phase) and similarly randomized therapy was given to 40 women with LPD and immature follicles. The incidence of pregnancies during an 8-month treatment period was as follows: pure LPD--23 of 50 women (77%) treated by PVS versus 5 of 30 women (17%) treated by BCT; LPD associated with immature follicles--3 of 20 women (15%) treated by PVS versus 14 of 20 women (70%) treated by BCT. Those women failing to conceive were now given the alternate therapy for the next 8 months.(ABSTRACT TRUNCATED AT 250 WORDS)