Resistant cases of polycystic ovarian disease successfully treated with a combination of corticosteroids, clomiphene, and bromocriptine

Eight successively examined anovulatory women with polycystic ovarian disease (PCOD) who had remained resistant to treatment with clomiphene and dexamethasone (DEX) (and some to hMG/hCG) and had mildly elevated prolactin levels were treated with a combination of clomiphene, DEX, and bromocriptine. There was a decrease in the LH:FSH ratio and androgen and prolactin levels to normal values; within five to eleven treatment cycles, all were pregnant. These results were probably achieved because of the inhibition of prolactin secretion by the dopamine agonist, but may also be due to repletion of a suggested possible functional depletion of dopamine within hypothalamic nuclei in PCOD. This combination treatment is therefore highly recommended before resorting to hMG/hCG therapy or surgery, both of which have intrinsic disadvantages.