Infertility in patients with hyperprolactinemia from a pituitary adenoma. Effect of transsphenoidal pituitary adenectomy

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Abstract
Four patients with infertility caused by a prolactin-secreting pituitary adenoma underwent transsphenoidal pituitary adenectomy. Preoperatively, in 3 patients the prolactin level was elevated and gonadotropin levels were depressed. In 1 patient, the prolactin level was elevated, and gonadotropin levels were normal, although no rise in gonadotropin levels was noted after clomiphene citrate therapy. In another patient the growth hormone level was elevated. Pituitary function was otherwise normal in all patients. The patients underwent transsphenoidal pituitary adenectomy and postoperatively the first 3 showed normal prolactin and growth hormone levels. The 4th has not yet been reevaluated. Spontaneous pregnancy occurred in all 4 patients without manipulation shortly after surgery. Transsphenoidal pituitary adenectomy is a successful and low risk approach to infertility secondary to prolactin secreting pituitary adenomas.

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