Cabergoline: an effective treatment for conception in prolactinoma

• Published in: BioMedica Vol. 38; no. 3; pp. 163 - 166
• Main Authors: Zahra Safdar, Omair Afzal, Rabia Nafees, Nabeel Choudhary
• Format: Journal Article
• Language: English
• Published: Discover STM Publishing Ltd 30-09-2022
• ISSN: 2710-3471
• DOI: 10.51441/BioMedica/5-750

Background and objective: Prolactinoma is an uncommon cause of amenorrhea and subfertility in females. When diagnosed, symptoms resolve with medical treatment in 90% of the cases. Conception and uneventful pregnancy, however, remain a big challenge in these patients. The objective of this study was to determine the therapeutic effectiveness of Cabergoline for conception in female patients with prolactinoma. The duration for restoration of menstruation, spontaneous conception, and outcomes of pregnancy were recorded over a period of 1 year in relation to prolactin level estimation.
Methods: This prospective study was carried over a period of 2 years from December, 2019 to December, 2021. A total of 696 female patients of reproductive age, diagnosed with prolactinomas, were included and randomly divided into 2 groups; A (Cabergoline) and B (Bromocriptine), and were given standard doses of both drugs. The duration for restoration of menstruation, spontaneous conception, and outcomes of pregnancy were recorded over a period of 1 year in relation to the serum prolactin level estimations.
Results: Most of the females were 25-30 years of age and most of them (98.2%) presented with amenorrhea. Restoration of menstruation was found to be earlier in group A, i.e., 3.6 months, as compared to group B, i.e., 5.8 months. Spontaneous conception within 6 months was observed in 42.6% of the patients of group A as compared to group B (26.8%). The rate of miscarriage was comparable in both groups. The live birth rate in the Cabergoline and Bromocriptine groups was 84% and 73.4%, respectively (p = 0.02). Mode of delivery was Caesarean section in both groups in all participants. Serum prolactin levels were significantly reduced in the Cabergoline group as compared to the Bromocriptine group (p = 0.035).
Conclusion: Cabergoline is an effective drug for spontaneous conception within 6 months of successful restoration of menstruation in female patients with prolactinomas. Live birth rate is also higher in the Cabergoline group as compared to the Bromocriptine group.