Postpartum return of pituitary and ovarian activity during lactation inhibition with the new dopamine agonist CV 205-502 and during normal lactation.
The new nonergot dopamine agonist CV 205-502 appears to be a promising alternative in the treatment of hyperprolactinemia. Regarding the potential use of CV 205-502 in infertility practice, we studied the influence of CV 205-502 on the return of endocrine fertility parameters during the physiological hyperprolactinemia of the puerperium. The resumption of pituitary and ovarian activity in 18 CV 205-502 treated women was compared with that in 10 bromocriptine-treated women. LH was measured by a new specific assay, which does not cross-react with hCG. This assay was also used in a second part of the study in which the pituitary function of 10 breast-feeding women was investigated. Both dopamine agonists adequately suppressed PRL. Pituitary secretion returned in the second week and was initially characterized by a high FSH/LH ratio. There were no major differences between CV 205-502 and bromocriptine. Ovulations occurred from day 18 on. The PRL rebound at the end of treatment seemed to play a role in the ovulation process. An acute increase of PRL just before midcycle was able to prevent ovulation. Breastfeeding women showed a delayed return of pituitary secretion: after a hypogonadotropic period, FSH returned in the third week and was followed by a period with a high FSH/LH ratio and follicular inactivity.
Kremer
J A
JA
Department of Reproductive Endocrinology and Infertility, St. Radboud University Hospital, Nijmegen, The Netherlands.
van der Heijden
P F
PF
Schellekens
L A
LA
Thomas
C M
CM
Brownell
J
J
Rolland
R
R
D000634:Aminoquinolines / Q000494:pharmacology*; D001971:Bromocriptine / Q000494:pharmacology; D015259:Dopamine Agents / Q000494:pharmacology*; D004958:Estradiol / Q000097:blood; D005260:Female; D005298:Fertility / Q000187:drug effects; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007774:Lactation / Q000187:drug effects*; D007986:Luteinizing Hormone / Q000097:blood; D010053:Ovary / Q000187:drug effects*; D010902:Pituitary Gland / Q000187:drug effects*; D049590:Postpartum Period / Q000187:drug effects*; D011388:Prolactin / Q000097:blood
D000634:Aminoquinolines; D015259:Dopamine Agents; D001971:Bromocriptine; D004958:Estradiol; C046650:quinagolide; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone