Analysis of therapeutic outcomes of polycystic ovary syndrome patients with hyperprolactinemia

Abstract

Objective To study effect of drug treatment in polycystic ovary syndrome patients with hyperprolactinemia.Methods We retrospectively studied 50 women with polycystic ovary syndrome and hyperprolactinemia from the outpatient between January 2005 and April 2008.Acccording to the beginning time of bmmocriptine.all women were divided into two groups.Groups Ⅰ was composed of 38 cases who received bromocriptine before induction of ovulation cycies,and the dose of bromocriptine was modulated depending on the level of serum prolaotin.When serum prolactin was controlled at normal levels,we decreased the dosage of bromocriptine step by step(1.25mg once),and then continued the treatment at maintenance dosage for no less than 3 weeks.After a baseline ultrasonographic examination on day 3,patients were treated with clomiphene citrate at a dosage of 100mg(2 tablets/day)for 5 days of a normal cycle or progesterone-induced bleeding.On day 9.we monitored the growth conditions of follicles routinely with trails-vagihal ultrasound.If there was no dominant follicle,we added human menopausal hormone(HMG 75U/d)to the protocol.Human chorionic gonadotropin(HCG,5 000-10 000IU)was given intramuscularly when the mean diameter of a follicle reached at least 18mm.At the same time we iustmcted the patients to have sexual intercourses or carried out artificial inseminations before and after ovulation.Group Ⅱ were 12 cases in which induction of ovulations were commenced almost simultaneously with beginning of bromeoriptine.The same protucol was given to patients in group Ⅱ.The procedures of ovulation induction and the outcomes of treatment were analyzed and compared.Results Compared with groupⅡ.the days of using HMG in group Ⅰ was shorter by instructing the time of sexual intercourse.The difference was significant(P=0.004).And there were similar rosults in the artificial insemination cycles(P=0.009).The rate of pregnancy in group Ⅰ(42% 16/38)was higher than that in group Ⅱ(25%,3/12),but the difference was not obvious.Conclusion Bromocriptine administration before the stimulated ovulation therapy can decrease the total dosage and treatment course of ovulating drugs.Induction of ovulations simultaneously with start of bromocriptine therapy can shorten the treatment time of infertility. Key words: Polycystic ovary syndrome; Hyperprolaotinemia; Infertility,female; Bromocriptine