Incidentally found small pituitary adenomas may have no effect on fertility

Histological examination of the pituitary glands from 486 unselected autopsies revealed 97 clinically unsuspected adenomas in 78 glands (16%). Prolactinomas numbered 48; no hormone was found in 30, LH in 8, ACTH in 7, growth hormone (GH) and prolactin in 3, and GH alone in 1. Eleven of 194 female subjects and 37 out of 292 males had one or more prolactinoma. Clinical case notes, available for 57 of 78 subjects with adenomas, were reviewed to obtain data on fertility. Of the 25 women with case notes, 6 of the 11 with prolactinomas and 11 of the 14 with adenomas of other types had conceived. For the 32 males, 10 of the 23 with prolactinomas and 5 of the 9 with other types had procreated. These findings show that pituitary tumours not identified in life may have no major anti-fertility effect, and suggest that treatment of small intrasellar lesions discovered clinically by chance may not be necessary.