Q: My elder sister who is 27 years old, is unmarried and since last 2 and a half years she is suffering from secondary amenorrhoea. Her first prolactin level was 45 microgm/L then she was started on bromocryptine in lower dose. Last year she stopped bromocryptine for sometimes because prolactin went down <0.50 microgm/L. But soon she had to start it again because prolactin level increased again. Since then she is taking bromocryptine 2.5 mg bd under the treatment of a gynaecologist. All this time she was amenorrhoeic. 2 months ago we changed our doctor and found that my sister is suffering from pituitary macroadenoma of about 3.5 cm size as CT scan and MRI reports say. We are going to bombay for operation. Now she has stopped taking bromocryptine because again prolactin is <0.50. What is the possibility of persistence of infertility? Actually she is still amenorrhoeic and one neurosurgeon says that still she may be infertile after operation, why? T3 T4 TSH LH FSH all are normal, then how can one say that fertility may not return? She is unmarried. We are trying for her marriage. Your answer will be very helpful for us.

A:The chance for remaining infertile would be higher if the symptoms persist like amenorrhoea or irregular bleeding after the surgery. Cases of pregnancy along with the tumour are also seen and chances for pregnancy will certainly improve after treatment - the risk of change in size of the tumour however can occur. I would plan the marriage and be optimistic about pregnancy later on, however the groom can be told about the tumour surgery, as family support would be needed later.