Prolactin resistance to bromocryptine treatment: a case report

High doses of bromocryptine (Parlodel, Sandoz) were successfully used for induction of ovulation followed by pregnancy in a hyperprolactinemic patient relatively resistant to bromocryptine treatment. After treatment with gradually increasing doses of bromocryptine, serum prolactin level (SPL) decreased slightly but became resistant and even elevated with increased doses. Under a high dose of bromocryptine (37.5 mg/d), the patient ovulated and conceived, despite the fact that SPL was not sufficiently reduced. The results may suggest that if a patient is somehow "resistant" to bromocryptine (as far as SPL suppression is concerned), a high dose may still be useful. The possibility that bromocryptine may have other effects on the process of ovulation than suppression of circulating prolactin is also to be considered.