Aggravation of Inappropriate Luteinizing Hormone Secretion by Bromocriptine in Polycystic Ovary Syndrome with Elevated Serum Dehydroepiandrosterone Sulfate.

Abstract

Ten clomiphene-resistant, normoprolactinemic women with polycystic ovary syndrome (PCOS) were treated by continuous and increasing administration of bromocriptine (Brc), and changes in hormonal profiles as well as therapeutic efficacy were examined. Ovulation was restored in four patients (responders), and two of them became pregnant, whereas the other six patients did not ovulate with Brc alone (non-responders).Endocrine analyses revealed distinct differences between responders and non-responders: 1) pretreatment serum levels of dehydroepiandrosterone sulfate (DHAS) in non-responders were significantly higher than those in responders:2) exaggerated LH secretion was definitely aggravated with Brc therapy in non-responders, but unchanged or slightly reduced in responders:3) basal PRL secretions showed a marked reduction in both groups, whereas this response to TRH in responders decreased more markedly than in non-responders with the therapy.It is concluded that low DHAS group patients of PCOS are likely to respond to Brc, whereas high DHAS group patients appear contraindicated for this treatment due to its aggravating effect on LH secretion.

Induction of Ovulation with Clomiphene Citrate Versus Clomiphene with Bromocriptine in PCOS Patients with Normal Prolactin: A Comparative Study

“…Though, the prolactin level significantly decreased in CC+Bcrt group, we could not demonstrate any remarkable change in ovulation as well as pregnancy rate. Studies done by Steingold et al, [17] and Takakura et al, [18] showed various changes in hormonal levels. Buvat et al, observed that there is no significant changes in hormonal profile and clinical characteristics after treatment, with the combination of bromocriptine and clomiphene citrate [19].The study done by Mohammad et al, had shown that the only significant long term bromocriptine therapy in clomiphene citrate resistant polycystic ovarian patients was to lower the serum prolactin concentration, which is similar to our study [20].…”