Cabergoline and Ganirelix Therapy for Early Moderate to Severe Ovarian Hyperstimulation Syndrome (OHSS) Results in Faster Recovery than in Early Untreated OHSS

Abstract

OBJECTIVE(S): To determine whether early-onset OHSS patients treated with cabergoline and ganirelix have more rapid symptom improvement and require less urgent care when compared with those with untreated early OHSS. DESIGN: Retrospective cohort study. MATERIALS AND METHOD(S): Consecutive patients with moderate to severe early OHSS between retrieval and ET from August 2008 until the present were included (n = 6). Early OHSS was defined as the development of symptoms presenting within 10 days from βhCG injection. All embryos were frozen, and patients received cabergoline 0.5 mg daily for 7 days and ganirelix 250 μg daily for 2 days. Day 0 was defined as the first day of treatment. Serial weights, number of urgent visits, and days of hospitalization were recorded. Controls were historical patients (n = 11) diagnosed with early-onset OHSS before initiation of the cabergoline/ganirelix protocol. Potential controls were excluded if no serial weights were documented in the medical record. Day 0 was defined as the date of diagnosis. The groups were compared using the Wilcoxon rank-sum test. RESULT(S): The results are presented in the table. CONCLUSION(S): This is the first report comparing patients treated with cabergoline and ganirelix in early-onset OHSS with early OHSS patients who did not receive therapy. Treated patients had more rapid weight loss at each time point, fewer unscheduled visits, and no hospital admissions. This protocol may represent a rapid and cost-effective outpatient therapy for patients diagnosed with moderate to severe early-onset OHSS.TableTreatment, median (25%, 75%)Control, median (25%, 75%)PAge27.0 (25.3, 33.0)32.0 (29.0, 34.0).13Body mass index23.3 (19.9, 24.8)20.8 (20.4, 21.2).51FSH units used4125 (1663, 4425)1500 (1200, 1875).04a.Peak E2, pg/dL6430 (5065, 8970)3335 (2481, 3890).003a.Follicles at retrieval53.5 (49.3, 55.5)35.5 (30.8, 44.8).03a.Oocytes30.5 (18.0, 40.0)25.0 (17.0, 31.0).56Weight change at day 2, kg−0.7 (−0.9, −0.5)+1.8 (+0.9, +2.8).003a.Weight change at day 4, kg−1.4 (−1.8, −1.4)+0.7 (+0.5, +1.4).004a.Weight change at day 7, kg−2.7 (−3.1, −1.8)−0.4 (−0.9, +1.6).03a.Unscheduled visits0.0 (0.0, 0.3)2.0 (1.0, 3.0).001a.No. of days of hospitalization0.0 (0.0, 0.0)6.0 (5.0, 11.0)<.001a.a . Open table in a new tab