The effect of pregnancy on suspected pituitary adenomas after conservative management of ovulation defects associated with galactorrhea

Abstract

Thirty intertile patients with ovulation defects and galactorrhea conceived after medical therapy: four after clomiphene stimulation (with or without hCG) and 26 after receiving CB-154 (2-Br-α-ergocryptine or bromergocryptine). Pregnancies were followed closely; sellar tomography and perimetry were repeated at 36 weeks' and 8 weeks' post partum. One patient required transsphenoidal adenectomy because of acute pituitary enlargement. Two developed minimal asymptomatic fossa enlargement. Lactation was suppressed with Lactostat in the first eight patients delivered; hyperprolactinemia, amenorrhea, and galactorrhea recurred. Five of eight showed asymptomatic enlargement of the sella. Bromergocryptine was used to suppress lactation in the rest. Long-term bromergocryptine therapy resulted in the restoration of euprolactinemic ovulatory cycles in all patients. These data suggest that patients with ovulation defects associated with galactorrhea can conceive with medical therapy now available. However, there is a risk of significant pituitary enlargement during pregnancy and the puerperium. Lactation should be suppressed with bromergocryptine.