Endocrine Abstracts

Purpose: The present study aimed at investigating the morphology and function of reproductive system in women with hyperprolactinemia (HPRL) receiving chronic treatment with cabergoline (CAB)

Methods: Twenty-three women(aged 34.21±10.09 yrs) with HPRL, including 17 with microprolactinoma, 3 with macroprolactinoma and 3 with iatrogenic HPRL, entered the study. All patients were well-controlled with CAB treatment (medium dose 0.46±0.45 mg/week). In population study, PRL at diagnosis (PRL0), PRL at evaluation (PRL1), FSH, LH,17B-estradiol (E2) and AMH in the early follicular phase(2°-5° days), and PRL(PRL2) and progesterone(PRO) in luteal phase(16°-25°day) were evaluated. Age at diagnosis(A0), age at evaluation(A1), CAB dose at evaluation (CE), mean (CM) and cumulative CAB dose (CD) and treatment duration (TD) were also evaluated. In both follicular and luteal phases, a transvaginal ultrasound was performed to evaluate: hysterometry (HS), endometrial thickness (ET), ovary length(dl), height (DAP), width (DT) and volume (OV), uterine volume (UV), right (AFR) and left (AFL) antral follicles count, right(RRI) and left (LFI) uterine artery resistance index, right (RPI) and left (LPI) pulsatility index. Based on CM, patients were stratified in Group 1 (CM<0.35 mg/week) and Group 2 (CM>0.35 mg/week). Based on TD, patients were stratified in Group 3 (TD<62 months) and Group 4 (TD>62 months).

Results: In Group 1, right DL (P=0.04), DT (P=0.016), DAP (P=0.023) and OV (P=0.002) during follicular phase were significantly higher than in Group 2. In Group3, right DL (P=0.004), DAP (P=0.023), DT (P=0.016) and OV (P=0.002) during follicular phase, and LPI (P=0.004) in luteal phase were significantly higher than in Group 4. In Group1, LH (P=0.044) and estradiol (P=0.023) during luteal phase were significantly higher than in Group 2, while no significant differences were found in hormonal profile between Group3 and Group4. In whole study population (n=23), PRL0 directly correlated with AMH (P=0.01) and PRO (P=0.002), whereas PRL1 with RRI (P<0.001) and PRL2 with AMH (P=0.02). TD indirectly correlated with ET (P=0.007), right DT (P=0.05) and DL (P=0.01), LPI (P=0.05) and RPI (P=0.0033), and directly with UV (P=0.02). CD indirectly correlated with LH (P=0.05) and right DL (P=0.048). A0 correlated indirectly with AFR (P=0.002), AFL (P=0.002) and AMH (P=0.012), and directly with UV (P=0.027) and CE (P<0.001). Similarly, A1 indirectly correlated with AFR (P=0.027), AFL (P=0.039) and AMH (P=0.003). E2 correlated directly with HS (P=0.044) and RRI (P=0.003), and indirectly with CD (P=0.036). In turn, AMH directly correlated with CE (P<0,0001), LPI (P<0,0001), and left DT (P=0.031).

Conclusion: CAB might have a direct beneficial effect on uterine and ovarian morphology and function, mainly improving uterine vascular flow parameters.