There are three basic issues that must be kept in mind for patients with prolactin adenoma who are planning or already pregnant: infertility, the possibility that the tumor may grow during pregnancy, and the effect of treatment on the fetus.
It is a normal physiological response to the proliferation of pituitary prolactin cells during pregnancy, which can even increase the size of the normal pituitary gland by a factor of two. It has been shown that fertility and eventual pregnancy can be achieved when treatment with bromocriptine is applied and the prolactin levels are restored to normal levels. Bromocriptine is often discontinued in the first trimester (3-4 weeks) after pregnancy and is not associated with an increased risk of spontaneous abortion or congenital malformations; even if bromocriptine is taken throughout pregnancy there is no clear association with to malformation.
In patients with prolactinomatous pituitary microadenomas who wish to become pregnant, bromocriptine has the same potential to regain fertility as surgery. Because common sense dictates that the fetus should be affected by bromocriptine for as short a time as possible, many physicians recommend that patients with pituitary microadenomas treated with bromocriptine discontinue the drug during the early stages of pregnancy, subject to close clinical monitoring for significant tumor enlargement.
For patients with prolactinomatous pituitary macroadenomas who wish to become pregnant, I personally recommend that surgery should be considered first because of the possibility of tumor enlargement during pregnancy. However, medication can also be applied, and surgery can be considered after pregnancy if symptoms of tumor enlargement are detected, but any surgery during pregnancy may induce miscarriage.
In addition, there is no definite answer as to whether pregnancy increases the risk of pituitary tumor stroke.
Preparation for pregnancy and management of prolactinoma during pregnancy is a complex issue and treatment must be highly individualized. You should establish contact with a medical professional and choose an appropriate plan together with your doctor.
Finally, we solemnly remind you that, in view of the continuous and infinite development of science and the limitations of your personal knowledge, the above scientific knowledge is for your information only. If you have or suspect that you have a pituitary adenoma, you should always go to a hospital to receive advice and treatment from an experienced specialist.