Effect of bromocriptine on sperm function in vitro and in vivo
Excess amounts of a hormone called prolactin in a woman's blood (hyperprolactinemia) is associated with amenorrhea (no menstruation) and infertility. Bromocriptine is a drug that reduces the amount of prolactin in the blood and is thus used to treat patients with hyperprolactinemia, especially when fertility is affected. The drug is given in low doses directly into the vagina, were it is readily absorbed. There are fewer side effects when this drug is given vaginally than when given orally. Since this drug is administered directly into the vagina, and is likely to be used by women who are infertile, the effects of bromocriptine on sperm motility (ability to ''swim'') and the ability of sperm to fertilize eggs were investigated. Samples of human sperm were obtained from 10 volunteers by masturbation and were placed in solutions containing different amounts of bromocriptine. The bromocriptine caused a 30 percent reduction in sperm motility. In the second part of the study, eight women with hyperprolactinemia and associated infertility administered their daily dose of bromocriptine four hours before having intercourse. Several hours after intercourse vaginal swabs were taken and examined under a microscope. All of the samples contained sperm that were motile. Five of the women became pregnant and gave birth to healthy babies. These findings indicate that bromocriptine does not impair sperm function since the women in this study were able to become pregnant. Based on these studies, it is concluded that bromocriptine, applied vaginally, can be used for the treatment of hyperprolactinemia and related infertility. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Cabergoline for hyperprolactinemia
Cabergoline seems to be more effective in restoring prolactin concentrations in the blood to normal levels than bromocriptine, the drug previously used for that purpose. Called Dostinex by Pharmacia & Upjohn, this ergot alkaloid derivative remains in the body approximately nine to 15 times as long as bromocriptine and produces side effects which are less severe. Its use should be avoided by patients with uncontrolled hypertension or those who are sensitive to ergot.
Publication Name: Medical Letter on Drugs and Therapeutics
In vitro fertilization
Several societal factors might contribute to infertility related to aging in women. Irrespective of the cause of infertility, the treatment that leads to the highest pregnancy rate per cycle is in vitro fertilization (IVF). The benefits and drawbacks of IVF are discussed with reference to the case of a 37-year-old woman and her 40-year-old husband who want to conceive a child through the process.
Publication Name: The New England Journal of Medicine
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