Clinical course and outcome of thirty-five pregnancies in infertile hyperprolactinemic women

Thirty-five pregnancies occurred during a 21-month follow-up period in 68 women (51%) who presented with infertility and hyperprolactinemia. Bromocriptine was used in 33 patients, of whom 25 (76%) conceived. In the remaining 35 patients who did not receive bromocriptine, there were 10 pregnancies (28%). The presence or absence of menses and galactorrhea in infertile hyperprolactinemic women treated with bromocriptine did not affect significantly the pregnancy rate. No pituitary complication occurred during pregnancy in any hyperprolactinemic patient and there was no change in sellar x-ray appearance, even in two patients whom a plain skull x-ray showed a minor sellar abnormality. Of the 35 pregnancies, 25 occurred after bromocriptine therapy, 2 after thyroxine therapy, 2 after clomiphene therapy, and 6 without any treatment. Five pregnancies ended in first-trimester abortion, including four after bromocriptine treatment. It is concluded that hyperprolactinemia is a good prognostic factor in infertility and that the majority of patients become fertile after a course of bromocriptine. No congenital abnormalities were observed in the offspring of patients treated with bromocriptine, but the abortion rate was higher than average.