Cabergoline: a safe, easy, cheap, and effective drug for prevention/treatment of ovarian hyperstimulation syndrome?

Targeting the vascular endothelial growth factor system to prevent ovarian hyperstimulation syndrome

“…Moreover, the administration of docarpamine (an oral dopamine prodrug) in 27 hospitalized patients gradually improved urinary output and ascites (Tsunoda et al, 2003). Cb2 was administered to 20 patients at risk of hyperstimulation on the evening after oocyte retrieval, and to 10 severely hyperstimulated hospitalized pregnant women (Manno et al, 2005). The authors reported the absence of OHSS in the group of at-risk patients and a prompt improvement in the hospitalized patients.…”

The effect of duration of coasting and estradiol drop on the outcome of assisted reproduction: 13 years of experience in 1,068 coasted cycles to prevent ovarian hyperstimulation

“…The hypothesis for a potential effect of Cd on cycle outcome is via both oocyte and endometrial factors. Although the falling FSH inducing an increase in apoptosis of granulosa cells is the mechanism postulated for the beneficial action of coasting, a prolonged duration may cause apoptosis of even the more mature follicles, with a subsequent effect on oocyte number and potentially on cycle cancellation rates (17,31). This mechanism is further supported by a recent study that demonstrated a predictive capability of FSH levels on the day of hCG for cycle outcome (ROC AUC 0.85, with a best discriminative value for cycle success of >4.9 IU/L) (37).…”

“…Other preventive measures, such as the cryopreservation of all embryos in an attempt to minimize the risk of ''late OHSS'' (11), follicular aspiration before hCG (12,13), and the administration of intravenous albumin (1,14) or hydroxyl-ethyl starch (15), have also been reported but remain unproven. More recently, reports have suggested a role for dopamine agonists, with a significant decrease in hematologic and clinical markers of OHSS as well as significant decrease in incidence of moderate OHSS compared with placebo by virtue of an inhibition of vascular permeability via dephosphorylation of the vascular endothelial growth factor receptor (16,17).…”

VEGF antagonist for the prevention of ovarian hyperstimulation syndrome: Current status

“…31 Encouraged by the various studies, many workers had tried cabergoline in OHSS prevention, administering the drug immediately after pick up or from the day of hCG administration and thus avoiding a possible detrimental effect on follicular growth and oocyte maturation due to VEGF system block, and found that none of the high risk patients treated, developed OHSS and data on pregnancy rates were comparable and implantation rates significantly higher than those observed in untreated high-responder controls. 32, 33 Youssef MA et al in a latest systematic review and meta-analysis have highlighted the prophylactic action of cabergoline, in lowering the incidence of OHSS and reiterated its efficacy.…”