Reproductive function and pregnancy outcomes in women treated for idiopathic hyperprolactinemia: A non-randomized controlled study

Background: Few studies have focused to determine the peculiarities of the course of pregnancy and pregnancy outcomes after treatment in women with idiopathic hyperprolactinemia.
Objective: To determine the peculiarities of the course of pregnancy and pregnancy outcomes in women treated for idiopathic hyperprolactinemia, with history of infertility and/or recurrent pregnancy loss.
Materials and Methods: A non-randomized controlled study was conducted at the Center for Reproductive Medicine “Universe” and Medical Clinic “Medhealth” during 2016-2018, involving 96 women with idiopathic hyperprolactinemia, aged 20-44 yr with infertility and/or a history of recurrent pregnancy loss. Prolactin (PRL), follicle-stimulating hormone, luteinizing hormone, estradiol (E2), free testosterone, and progesterone were studied in blood serum using immunoassay analysis method. Before the occurrence of pregnancy, hyperprolactinemia was treated with bromocriptine. Dydrogesterone was used to support the luteal phase.
Results: PRL levels decreased significantly and normalized within two-five months, regular menstrual cycle was restored in two-four months, ovulation was restored in three-seven months, and pregnancy was achieved in three-fourteen months. E2 and progesterone levels increased significantly (p < 0.001). Prior to the treatment, significant negative correlation between PRL and E2 (r = -0.386, p = 0.007), PRL and progesterone (r = -0.420, p = 0.003) was detected. Threatened early abortion prevailed among pregnancy complications. Pregnancy loss in the first trimester was recorded in 3.12% of cases.
Conclusion: Pregnancy outcomes in women with idiopathic hyperprolactinemia are improved by prolonged and continuous treatment with bromocriptine before pregnancy and administration of dydrogesterone in support of the luteal insufficiency.