Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021359 (infertility)
 26,075 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of bromocriptine administration was studied in 34 patients, whose presenting symptoms included amenorrhoea, galactorrhoea, infertility, dyspareunia, delayed puberty, and impotence. Two patients were found to have raised plasma prolactin values during investigation for acromegaly. With the exception of three individuals all patients had hyperprolactinaemia. Pituitary fossa enlargement or asymmetry was reported in 16 patients and one patient had primary hypothyroidism. Virtually all patients complained of side effects when first starting bromocriptine but only two patients were unable to tolerate prolonged therapy with doses which ranged from 5--40 mg daily. A single oral dose of 2.5 mg resulted in a greater than 50% reduction in plasma prolactin within five hours in 22 of 26 patients. Over the course of one month, five patients with significant pituitary fossa enlargement appeared to show less rapid suppression of plasma prolactin than five patients without fossa enlargement. At two months this trend was still evident but eventually all patients showed acceptable control of plasma prolactin, with the exception of one patient who required pituitary surgery. Galactorrhoea ceased in 13 of 15 patients, menstrual periods resumed in ten of 13 patients, two patients becoming pregnant first. Potency returned and puberty proceeded in two hypogonadal males. Six of the nine patients requesting treatment for infertility became pregnant. It is concluded that bromocriptine provides effective treatment for galactorrhoea, amenorrhoea or gonadal disorders when there is associated hyperprolactinaemia.
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PMID:Treatment of amenorrhoea, galactorrhoea and hypogonadism with bromocriptine. 27 21

Because of the poor results and the morbidity associated with surgical and radiation treatment of pituitary adenomas, investigators continue to search for new pharmacologic tools to treat anterior pituitary hyperfunction. New drugs are being studied in the treatment of acromegaly, Cushing's disease, and galactorrhea-amenorrhea, infertility, and impotence associated with prolactin-secreting pituitary tumors.
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PMID:New drugs in the treatment of pituitary disorders. 33 37

Bromocriptine, a dopaminergic agonist, has been used to treat many endocrine disorders. In hyperprolactinemia associated with galactorrhea, amenorrhea, oligospermia, and impotence, bromocriptine reduces prolactin levels to normal and allows for satisfactory return of sexual and reproductive function in 90% of patients. In acromegaly, bromocriptine brings about subjective improvement in 75% of patients with reduction in growth-hormone levels to normal in 22% of patients. Bromocriptine has been used in premenstrual tension, functional infertility, Nelson's syndrome, and Cushing's disease with variable benefit. In low doses, side-effects are minimal. In higher doses, digital vasospasm and gastrointestinal bleeding have occurred. Although bromocriptine has been used in a wide variety of endocrine disorders, it appears to be most useful in treatment of male and female infertility associated with hyperprolactinemia.
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PMID:Bromocriptine and endocrine disorders. 44 91

The pituitary gonadal-axis has been studied in 25 cases of PRL-secreting adenomas in men. Besides impotence, infertility, arrest or lack of puberty may be observed, basal levels of LH and FSH are in the low normal range but a weak increase of LH is observed after LH-RH. Testosterone (T) levels are low in most of the patients and only normal in 5. In two cases with actively secreting-PRL adenomas, normal circadian rhythms of T and PRL are abolished. After CB 154 treatment, an improvement of the clinical and biological symptoms is observed in 8 out of 10 men. An increase of LH response to LH-RH under CB 154 is obtained in 5 cases. This is in favour of a functional effect of the hyperprolactinemia on the pituitary.
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PMID:[Prolactin-secreting adenomas in males. Study of the hypophyseal-gonadal axis]. 44 43

Male hyperprolactinemia was detected in 4% (7 of 171) of infertile men. In seven patients with excessive serum prolactin concentrations, the clinical manifestations were infertility, hypogonadism, impotence, and galactorrhea and the etiologic factors were pituitary adenoma, hypothalamic dysfunction, drug use, and idiopathic. The testes and prostate were small or normal and the semen analysis revealed low semen volume, normal or low sperm count, and normal or impaired sperm motility. The testicular biopsy showed normally preserved seminiferous tubules with normal or decreased spermatogenesis and damaged or fibrotic seminiferous tubules among normal ones. Patients with hyperprolactinemia were investigated by sellar polytomography, visual field examinations, and hormone assays. Treatment with bromocriptine (Parlodel) gave satisfactory results in all patients. The use of bromocriptine with human menopausal gonadotropin and human chorionic gonadotropin was beneficial in treating hypogonadotropic hypogonadism with hyperprolactinemia.
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PMID:Male hyperprolactinemia:effects on fertility. 49 87

Since the radioimmunoassay for serum prolactin became available eight years ago, prolactin has become a hormone of considerable clinical interest. An elevated serum prolactin concentration is the most frequent hormone marker for pituitary tumors. Secreted in excess, prolactin causes dysfunction of the hypothalamic-pituitary axis, the gonads, and the adrenal cortex. In women, menstrual disturbances, galactorrhea, infertility, and hirsutism result. Impotence, oligospermia, and decreased libido are common in men. These metabolic abnormalities attributed to prolactin excess are corrected when prolactin concentrations are lowered by either medical or surgical therapy. The availability of effective therapy mandates early recognition and proper management of the patient with hyperprolactinemia.
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PMID:Hyperprolactinemia--a review of recent clinical advances. 51 24

A 30-year-old man with a prolactin secreting pituitary adenoma and hypogonadism was studied. Except for hyperprolactinemia, the results of his pituitary function tests were perfectly normal. Although the mechanism is uncertain, hyperprolactinemia alone may interfere with male reproductive function. The patient's impotence and infertility were successful managed with injections of human menopausal gonadotropins (HMG). Adverse interaction between gonadotropins and prolactin along the hypothalamic-pituitary-testis axis may be corrected by HMG injections in certain cases.
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PMID:Management of male hyperprolactinemic hypogonadism. 66 24

Impotence, infertility and feminization have been frequently reported among male cirrhotic patients. Previous studies have suggested that liver disease was the basis of these effects. Recent clinical and laboratory experimental studies have suggested that alcohol consumption may have a direct effect on both testosterone metabolism and spermatogenesis. The effect may be mediated through the central nervous system or directly on the testes. The present study compared the pathology in the liver and testes and the estimated alcohol consumption among men who had died suddenly from a variety of causes. Of 137 men studied, 20(14%) had moderate to severe decrease in spermatogenesis. Only 9 of 19 with decreased spermatogenesis also had severe or very severe fatty infiltration of the liver. However, 17 of 19 were classified as heavy alcohol drinkers and 14 were estimated to consume at least 417 gm of alcohol per week. Finally, the alcohol history was reviewed in relation to liver and testicular pathology. Only a weak association between the liver and testes pathology was noted.
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PMID:The relationship between alcohol, liver disease, and testicular pathology. 70 87

Azoospermia was diagnosed in six factory workers who had been chronically exposed to 1,2-dibromo-3-chloropropane. Infertility was the presenting symptom in two patients and a decrease in libido or impotence characterized the others. Hormone studies revealed elevated plasma follicle-stimulating hormone levels and normal plasma luteinizing hormone and testosterone concentrations. Testicular biopsy showed selective atrophy of the germinal epithelium, intact Sertoli cells, and a normal appearance of a relatively increased number of Leydig cells.
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PMID:Suppressive effect of 1,2-dibromo-3-chloropropane on human spermatogenesis. 71 Jun 16

Prolactin was isolated and identified as a separate pituitary hormone distinct from human growth hormone. Since that time a rapidly expanding literature has accumulated on the physiology of pituitary prolactin secretion in normal and pathologic conditions. Currently the physiology and pathophysiology of pituitary prolactin secretion are under intensive investigation. Development of sensitive, specific radioimmunoassay for prolactin and improved roentgenographic techniques have increased the diagnostic acumen for incipient pituitary microadenomas. Dynamic function tests of prolactin secretion have not helped to distinguish whether a patient has a microadenoma or not. The basal prolactin level is probably the most useful single investigation for diagnosis a pituitary tumour. If women with pituitary tumours have ovulation induced with bromocriptine therapy, then there is a considerable risk of rapid enlargement of the tumour with the development of serious visual field defects often during the last trimester. The precise level of the risk is not clear, but is probably not great. The introduction of bromocriptine has heralded a major change in the menagement of the hyperprolactinaemia-hypogonadism syndromes and resulted in safer and easier treatment of many cases of infertility, menstrual disorders and, to a lesser extent of impotence. At present, bromocriptine therapy is the treatment of choice for hyperprolactinaemia.
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PMID:[Prolactin and human reproduction]. 75 1


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