Failure of cabergoline to prevent severe ovarian hyperstimulation syndrome in patients with extremely high estradiol levels

Hwang, Jiann Loung; Lin, Yu Hung; Seow, Kok-Min

doi:10.1016/j.ijgo.2009.09.017

Cited by 11 publications

(7 citation statements)

References 4 publications

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“…[11] In pursuance, Cb2 was therefore extensively studied and was found to bring about a decrease in the severity or incidence or both of OHSS. [1213141516]…”

Section: Discussionmentioning

confidence: 99%

Calcium gluconate infusion is as effective as the vascular endothelial growth factor antagonist cabergoline for the prevention of ovarian hyperstimulation syndrome

Naredi¹,

Karunakaran²

2013

J Hum Reprod Sci

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BACKGROUND:Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic and potentially life-threatening disease process, which may occur in healthy young women undergoing controlled ovarian hyperstimulation for assisted reproduction. As the treatment is largely empirical, prevention forms the mainstay of management.OBJECTIVE:The present study was aimed to evaluate the effectiveness of intravenous (IV) calcium gluconate infusion in comparison to the dopamine agonist cabergoline (Cb2) in preventing OHSS in high risk patients undergoing assisted reproductive technique cycles.MATERIALS AND METHODS:It was a comparative study wherein the 202 high risk patients undergoing in vitro-fertilization over a period of 18 months after meeting the strict inclusion and the exclusion criteria, were randomly divided into two groups (98 subjects in Group I and 104 in Group II). Women in Group I were administered IV calcium gluconate while the remaining 104 received the dopamine agonist Cb2. The 104 patients belonging to Group II were started Cb2 0.5 mg/day from the day of ovulation trigger and continued until the next 8 days while the 98 high risk patients from Group I were infused with 10 ml of 10% calcium gluconate solution in 200 ml physiologic saline within 30 min of ovum pick up and continued thereafter on day 1, day 2 and day 3.RESULTS:The occurrence of OHSS was seen in only nine patients (in the calcium infusion group, when compared with 16 patients (9.2% vs. 15.4%) who were administered Cb2, but it was not statistically significant. However, only one had severe OHSS in Group I, whereas two women were diagnosed as severe OHSS belonging to the Cb2 arm.CONCLUSION:Our results document that calcium infusion can effectively prevent severe OHSS and decreases OHSS occurrence rates when used for high-risk patients, but does not suggest its superiority over Cb2. With comparable success rates, either of them can be employed as a preventive strategy for OHSS.

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“…[11] In pursuance, Cb2 was therefore extensively studied and was found to bring about a decrease in the severity or incidence or both of OHSS. [1213141516]…”

Section: Discussionmentioning

confidence: 99%

Calcium gluconate infusion is as effective as the vascular endothelial growth factor antagonist cabergoline for the prevention of ovarian hyperstimulation syndrome

Naredi¹,

Karunakaran²

2013

J Hum Reprod Sci

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“…Cb2 is the most commonly used dopamine agonist for OHSS prevention [12]. Cb2 has been examined with a decrease in the severity and incidence of OHSS [13]- [16]. Randomized controlled trials, which are more important for us, have indicated that the same results were verified.…”

Section: Discussionmentioning

confidence: 99%

The Importance of Prolactin Levels in Patients Treated with Cabergoline for the Prevention of OHSS: Is Cabergoline Really Effective in Patients with High Risk of OHSS?

Oral¹,

Akpak²,

Karaca³

et al. 2015

OJOG

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Background: OHSS is a dangerous and potentially life-threatening condition for which many researchers look for new ways to treat. Aim: To determine the effectiveness of prophylactic cabergoline administration on prolactine levels in patients with high risk for ovarian hyperstimulation syndrome (OHSS). Material and Methods: 163 in vitro fertilisation (IVF) patients with high risk for OHSS were enrolled in the study. The criteria for inclusion were more than 15 oocytes retrieved at oocyte pick up. A standard antagonist protocol was used for ovulation induction. Cabergoline treatments (0.5 mg/day) were started on the day of oocyte retrieval and continued for eight days. Prolactine levels were measured at the day of oocyte retrieval and the 9th day after the oocyte retrieval. Results: Of the 163 patients, 26 (15.9%) had OHSS. Prolactine levels on the day of oocyte retrieval were 44.22 ± 24.78 ng/mL and 37.6 ± 22.5 ng/mL in patients with OHSS and without OHSS, respectively (P > 0.05). In contrary prolactine levels were significantly higher in patients with OHSS patients (3.9 ± 5.07 ng/mL) than in patients without OHSS (2.1 ± 2.92 ng/mL) at the 9th day after oocyte retrieval (P < 0.05). Conclusion: Prolactine levels were higher in patients with OHSS than without OHSS who were treated with cabergoline for the prevention of OHSS.

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“…One study proved that the combined administration provided better protection without notable side effects [18]. However, Hwang [19] pointed out that the efficacy of cabergoline is not good in preventing severe OHSS through two cases.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Cabergoline and Coasting in Prevention of the Ovarian Hyperstimulation Syndrome in Patients Undergoing IVF/ICSI-ET Treatment: A Systematic Review and Meta-Analysis

Liu¹,

Wang²,

Meng³

et al. 2020

ARSci

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Objective: To compare the effectiveness of two methods in preventing ovarian hyperstimulation syndrome (OHSS) with cabergoline and coasting. Design: Systematic review and meta-analysis of randomized clinical trials (RCTs). Patients: Women were considered as have risk of OHSS undergoing fertility treatment. Interventions: Cabergoline, coasting. Result: There were included five RCT studies. The clinical pregnancy rate was no significantly difference between two groups (RR 1.22, 95% CI [0.86, 1.71]), implantation rate (RR 1.00, 95% CI [0.75, 1.32]), severe OHSS (RR 0.93, 95% CI [0.38, 2.31]), fertilization rate (SMD 0.70, 95% CI [−0.10, 1.50]), number of oocytes retrieved (SMD 0.80, 95% CI [0.30, 1.30]), number of embryo transfer (SMD-0.04, 95% CI [−0.24, 0.17]), E 2 value on the day of HCG injection (SMD 0.21, 95% CI [−0.25, 0.68]), number of MII oocytes (SMD 0.71, 95% CI [0.32, 1.11]), abortion rate (RR 0.61, 95% CI [0.21, 1.83]), number of follicles > 17 mm on day of HCG (SMD-0.01, 95% CI [−0.26, 0.24]), number of follicles 15-17 mm on day of HCG (SMD −0.08, 95% CI [−0.33, 0.17]), number of follicles 10-14 mm on day of HCG (SMD −0.06, 95% CI [−0.31, 0.19]). Conclusion: Both cabergoline and coasting prevent the occurrence of OHSS, but no statistically significant difference between them. Compared with coasting group, a daily dose of 0.5 mg cabergoline significantly increased the number of oocytes retrieved, MII oocytes, and fertilization rate, but decreased the abortion rate.

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Failure of cabergoline to prevent severe ovarian hyperstimulation syndrome in patients with extremely high estradiol levels

Cited by 11 publications

References 4 publications

Calcium gluconate infusion is as effective as the vascular endothelial growth factor antagonist cabergoline for the prevention of ovarian hyperstimulation syndrome

Calcium gluconate infusion is as effective as the vascular endothelial growth factor antagonist cabergoline for the prevention of ovarian hyperstimulation syndrome

The Importance of Prolactin Levels in Patients Treated with Cabergoline for the Prevention of OHSS: Is Cabergoline Really Effective in Patients with High Risk of OHSS?

The Influence of Cabergoline and Coasting in Prevention of the Ovarian Hyperstimulation Syndrome in Patients Undergoing IVF/ICSI-ET Treatment: A Systematic Review and Meta-Analysis

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