Etiology of OHSS and use of dopamine agonists

Soares, Sérgio Reis

doi:10.1016/j.fertnstert.2011.12.046

Cited by 53 publications

(40 citation statements)

References 75 publications

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“…It would be preferable to start with the treatment a few hours before the injection of hCG, to enable the presence of dopamine agonists before the rise in VEGF production. Cabergoline is currently used at a daily dose of 0.5 mg for eight days despite its long half-life (65-69 h) because it is the best known eff ective regimen with good tolerability, in addition to rectal bromocriptine at a daily dose of 2.5 mg for sixteen days as an alternative 45 . In hyperstimulated women undergoing ART, cabergoline successfully reduces hemoconcentration and ascites as a well-established and safe medication in the prevention of OHSS 46 .…”

Section: Dopamine Agonistsmentioning

confidence: 99%

“…Furthermore, there was no evidence indicating that minimal stimulation regimens diff ered signifi cantly from gonadotropins in GnRH agonist protocols in terms of OHSS incidence and live births or pregnancy rates. According to fi ndings from a Cochrane analysis, the use of CC with gonadotropins (with or without mid-cycle antagonist) led to a reduction in the incidence of OHSS varying between 0.8% and 1.8%, compared with 3.5% preva- Casper et al 12 Engmann et al 14 Gülekli et al 16 Humaidan et al 21 Griesenger et al 22 Fatemi et al 45 Tang et al 47 Leitao et al 48 Youssef et al 49 Alvarez et al 50 Busso et al 51 Baumgarten et al Nastri et al 8 Zarek et al 55 Rinaldi et al 56 Casano et al 57 Gibrel et al 58 Figueiredo et al 59 Mild ovarian response Less drug use and lower cost Lower incidence of OHSS Satisfactory pregnancy rates and pregnancy outcome…”

Section: Mild Stimulation Protocolsmentioning

confidence: 99%

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Current Medical Strategies in the Prevention of Ovarian Hyperstimulation Syndrome

Kasum

Orešković

Franulić

et al. 2017

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SUMMARY -Th e purpose of this review is to analyze current medical strategies in the prevention of ovarian hyperstimulation syndrome (OHSS) during ovarian stimulation for in vitro fertilization. Owing to contemporary preventive measures of OHSS, the incidence of moderate and severe forms of the syndrome varies between 0.18% and 1.40%. Although none of medical strategies is completely eff ective, there is high-quality evidence that replacing human chorionic gonadotropin (hCG) by gonadotropin-releasing hormone (GnRH) agonists after GnRH antagonists and moderate-quality evidence that GnRH antagonist protocols, dopamine agonists and mild protocols reduce the occurrence of OHSS. Among various GnRH agonists, buserelin 0.5 mg, triptorelin 0.2 mg and leuprolide acetate (0.5-4 mg) have been mostly utilized. Although GnRH trigger is currently regarded as the best tool for OHSS prevention, intensive luteal support with exogenous administration of estradiol and progesterone or low-dose hCG on the day of oocyte retrieval or on the day of GnRH agonist trigger are required to achieve optimal conception rates due to early luteolysis. Among currently available dopamine agonists, cabergoline, quinagolide and bromocriptine are the most common drugs that should be used for prevention of both early and late OHSS. Mild stimulation protocols off er attractive option in OHSS prevention with satisfactory pregnancy rates.

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Section: Dopamine Agonistsmentioning

confidence: 99%

Section: Mild Stimulation Protocolsmentioning

confidence: 99%

Current Medical Strategies in the Prevention of Ovarian Hyperstimulation Syndrome

Kasum

Orešković

Franulić

et al. 2017

acc

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“…From a therapeutical point of view in patients with OHSS, gonadotropin-releasing hormone agonists can modulate vascular permeability via influencing the expression of the TJ protein Claudin 5 (Kitajima et al 2006). Furthermore, in patients at risk of OHSS, the effect of VEGF on junctional proteins can be also inhibited by dopamine agonists, thus decreasing vascular permeability (Gomez et al 2011, Kumar et al 2011, Soares 2012. Several lines of evidence have also implicated dopamine as an etiological factor in the OHSS.…”

Section: R75mentioning

confidence: 99%

Regulation of endothelial permeability in the primate corpora lutea: implications for ovarian hyperstimulation syndrome

Herr¹,

Bekes²,

Wulff³

2015

Reproduction

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In a developing human corpus luteum, a closely regulated cellular communication system exists between the luteal steroidogenic cells and endothelial cells. This system guaranties the vascularization process during luteal formation. The process is combined with rapid release of large amounts of progesterone into the bloodstream. The regulation of endothelial proliferation and permeability by LH and human chorionic gonadotropin (hCG) is integral to this process. On the cellular level, endothelial permeability is regulated by intercellular junctions, such as adherens junctions (AJ) and tight junctions (TJ), which act as zipper-like structures between interacting endothelial cells. Several cell junctional proteins are localized to the corpus luteum, including Occludin, Nectin 2, Claudin 1, and Claudin 5, as well as, vascular endothelial (VE)-Cadherin. It has been assumed that regulation of AJ-and TJ-proteins is of particular importance for permeability, and accordingly, for the functionality of the corpus luteum in early pregnancy, because treatment with hCG induces downregulation of juntional proteins in the luteal vessels. The effect of hCG on the adhesive molecules is mediated by VE growth factor (VEGF). On a functional level, the hCG-dependent and VEGF-mediated decrease in junctional proteins causes a decrease in the density of cell-cell closure and, accordingly, an increase in endothelial permeability. In doing so, the different junctional proteins are not only directly influenced by VEGF but also interact among themselves and influence each other reciprocally. Disturbances in this strictly, regulated interactions may explain the development of pathologies with increased vascular permeability, such as the ovarian hyperstimulation syndrome.Reproduction (2015) 149 R71-R79

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“…OHSS is associated with unrestrained formation of blood vessels and increased capillary permeability; PCOS is characterized with an excessive vascular formation (Amin et al 2003). Thus, the development of therapies to these syndromes depends mainly on understanding the mechanism of ovarian angiogenesis (Soares 2011). OHSS is an iatrogenic complication, caused by ovarian stimulation with exogenous gonadotropins and ovulation induction by hCG to trigger oocyte maturation, particularly during IVF treatments (Humaidan et al 2010).…”

Section: R54 D Chuderland and Othersmentioning

confidence: 99%

Role of pigment epithelium-derived factor in the reproductive system

Chuderland¹,

Ben‐Ami²,

Bar‐Joseph³

et al. 2014

Reproduction

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The physiological function of the female reproductive organs is hormonally controlled. In each cycle, the reproductive organs undergo tissue modifications that are accompanied by formation and destruction of blood vessels. Proper angiogenesis requires an accurate balance between stimulatory and inhibitory signals, provided by pro-and anti-angiogenic factors. As with many other tissues, vascular endothelial growth factor (VEGF) appears to be one of the major pro-angiogenic factors in the female reproductive organs. Pigment epithelium-derived factor (PEDF) is a non-inhibitory member of the serine protease inhibitors (serpin) superfamily, possessing potent physiologic anti-angiogenic activity that negates VEGF activity. The role of PEDF in decreasing abnormal neovascularization by exerting its anti-angiogenic effect that inhibits pro-angiogenic factors, including VEGF, has been investigated mainly in the eye and in cancer. This review summarizes the function of PEDF in the reproductive system, showing its hormonal regulation and its anti-angiogenic activity. Furthermore, some pathologies of the female reproductive organs, including endometriosis, ovarian hyperstimulation syndrome, polycystic ovary syndrome, and others, are associated with a faulty angiogenic process. This review illuminates the role of PEDF in their pathogenesis and treatment. Collectively, we can conclude that although PEDF seems to play an essential role in the physiology and pathophysiology of the reproductive system, its full role and mechanism of action still need to be elucidated.Reproduction (2014) 148 R53-R61

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Etiology of OHSS and use of dopamine agonists

Cited by 53 publications

References 75 publications

Current Medical Strategies in the Prevention of Ovarian Hyperstimulation Syndrome

Current Medical Strategies in the Prevention of Ovarian Hyperstimulation Syndrome

Regulation of endothelial permeability in the primate corpora lutea: implications for ovarian hyperstimulation syndrome

Role of pigment epithelium-derived factor in the reproductive system

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