A 30-year-old woman has secondary amenorrhea for 8 months and galactorrhea. Pregnancy test is negative. Prolactin is 118 ng/mL, TSH is normal, and

Question

A 30-year-old woman has secondary amenorrhea for 8 months and galactorrhea. Pregnancy test is negative. Prolactin is 118 ng/mL, TSH is normal, and MRI shows a 6-mm pituitary lesion. She wants pregnancy in the next year. Which of the following is the most appropriate next step in management?

Accepted Answer

Dopamine agonist therapy

Answer

Transsphenoidal surgery as first-line therapy

Answer

Pituitary radiation

Answer

Combined oral contraceptives as definitive therapy

Answer

Observation despite infertility goals

Microprolactinoma with infertility — USMLE Step 3 MCQ

A 30-year-old woman has secondary amenorrhea for 8 months and galactorrhea. Pregnancy test is negative. Prolactin is 118 ng/mL, TSH is normal, and MRI shows a 6-mm pituitary lesion. She wants pregnancy in the next year. Which of the following is the most appropriate next step in management?