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Prolactinomas: Preconception and During Pregnancy.

Catherine D Zhang1, Adriana G Ioachimescu2

  • 1Department of Medicine, Division of Endocrinology and Molecular Medicine, Medical College of Wisconsin, HUB for Collaborative Medicine, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA.

Endocrinology and Metabolism Clinics of North America
|July 31, 2024
PubMed
Summary
This summary is machine-generated.

Prolactinomas, common causes of infertility, are effectively treated with dopamine agonists (DAs) during pregnancy. Management strategies vary for micro- and macroprolactinomas, requiring multidisciplinary care for complex cases.

Keywords:
ApoplexyFertilityHyperprolactinemiaPreconceptionPregnancyProlactinoma

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Area of Science:

  • Reproductive Endocrinology
  • Neuroendocrinology
  • Oncology

Background:

  • Prolactinomas are pituitary tumors that secrete prolactin, frequently causing infertility in women.
  • Dopamine agonists (DAs) are the primary medical treatment, demonstrating high efficacy and safety in pregnancy.
  • Surgical intervention is reserved for specific cases, including large tumors or inadequate medical response.

Purpose of the Study:

  • To provide an updated review on the management and outcomes of prolactinomas.
  • To discuss the approach to prolactinomas before conception, during pregnancy, and postpartum.
  • To highlight the importance of a multidisciplinary team in managing complex cases.

Main Methods:

  • Literature review of recent studies on prolactinoma management.
  • Synthesis of clinical guidelines and expert recommendations.
  • Analysis of outcomes related to fertility restoration and pregnancy course.

Main Results:

  • Dopamine agonist therapy is highly effective for fertility restoration and safe in early pregnancy.
  • Microprolactinomas generally result in uneventful pregnancies.
  • Macroprolactinomas near the optic chiasm may enlarge during pregnancy, necessitating close monitoring and intervention.

Conclusions:

  • Medical management with dopamine agonists is the cornerstone for prolactinomas, especially during pregnancy.
  • Individualized management plans are crucial, considering tumor size and proximity to critical structures.
  • A multidisciplinary approach ensures optimal outcomes for women with prolactinomas throughout their reproductive journey.