The effects of cabergoline on ovarian hyperstimulation syndrome (OHSS) and pregnancy outcomes on in vitro fertilization (IVF) patients

Abstract

ObjectiveTo compare the outcomes between patients who used cabergoline and those who did not to prevent ovarian OHSS while undergoing IVF.DesignRetrospective analysis.Materials and MethodsBetween 2008 and 2011, 120 patients at risk for OHSS received 0.5 mg of cabergoline daily starting on the day of HCG administration and 211 patients did not receive any treatment to prevent OHSS. Inclusion criteria included a maximum estradiol level greater than 3500. IVF stimulation regimens included long GnRH agonist and antagonist protocols with combined human menopausal gonadotropins (hMG) and recombinant follicle stimulating hormone (rFSH) protocols. Oocytes were fertilized and embryos were transferred or frozen as determined by their risk for OHSS. Moderate and severe OHSS were defined by Rizk's criteria.Statistical analysis was performing using the t-test for age, estradiol level, and oocytes retrieved. A chi square test was used for hospital admissions, rate of OHSS, and pregnancy rate.ResultsTable 1Comparison of patients recieving cabergoline (cabergoline) and patients who did not recieve treatment for prevention of OHSS (control).CabergolineControlP valueAge34.6 ± 4.733.5 ± 4.80.074MAXIMUM ESTRADIOL4780.4 ± 1114.84592.1 ± 998.40.067ESTRADIOL ON DAY OF HCG4003.9 ± 994.63714.2 ± 995.00.002*OOCYTES RETRIEVED16.3 ± 6.815.3 ± 6.50.228HOSPITALIZATION (%)1.74.60.167MODERATE OHSS (%)1.75.50.091SEVERE OHSS (%)0.00.90.294TOTAL OHSS (%)1.76.50.050*PREGNANCY (%)49.649.80.973* statistically significant Open table in a new tab ConclusionCabergoline administration did not affect the rate of hospital admissions or severe OHSS, however, did significantly reduce the total number of OHSS cases. In addition, using cabergoline did not affect overall clinical pregnancy rate. The overall incidence of OHSS is very low and despite the large numbers of treated subjects, a larger study may be necessary to generate sufficient power to accurately assess efficacy. ObjectiveTo compare the outcomes between patients who used cabergoline and those who did not to prevent ovarian OHSS while undergoing IVF. To compare the outcomes between patients who used cabergoline and those who did not to prevent ovarian OHSS while undergoing IVF. DesignRetrospective analysis. Retrospective analysis. Materials and MethodsBetween 2008 and 2011, 120 patients at risk for OHSS received 0.5 mg of cabergoline daily starting on the day of HCG administration and 211 patients did not receive any treatment to prevent OHSS. Inclusion criteria included a maximum estradiol level greater than 3500. IVF stimulation regimens included long GnRH agonist and antagonist protocols with combined human menopausal gonadotropins (hMG) and recombinant follicle stimulating hormone (rFSH) protocols. Oocytes were fertilized and embryos were transferred or frozen as determined by their risk for OHSS. Moderate and severe OHSS were defined by Rizk's criteria.Statistical analysis was performing using the t-test for age, estradiol level, and oocytes retrieved. A chi square test was used for hospital admissions, rate of OHSS, and pregnancy rate. Between 2008 and 2011, 120 patients at risk for OHSS received 0.5 mg of cabergoline daily starting on the day of HCG administration and 211 patients did not receive any treatment to prevent OHSS. Inclusion criteria included a maximum estradiol level greater than 3500. IVF stimulation regimens included long GnRH agonist and antagonist protocols with combined human menopausal gonadotropins (hMG) and recombinant follicle stimulating hormone (rFSH) protocols. Oocytes were fertilized and embryos were transferred or frozen as determined by their risk for OHSS. Moderate and severe OHSS were defined by Rizk's criteria. Statistical analysis was performing using the t-test for age, estradiol level, and oocytes retrieved. A chi square test was used for hospital admissions, rate of OHSS, and pregnancy rate. ResultsTable 1Comparison of patients recieving cabergoline (cabergoline) and patients who did not recieve treatment for prevention of OHSS (control).CabergolineControlP valueAge34.6 ± 4.733.5 ± 4.80.074MAXIMUM ESTRADIOL4780.4 ± 1114.84592.1 ± 998.40.067ESTRADIOL ON DAY OF HCG4003.9 ± 994.63714.2 ± 995.00.002*OOCYTES RETRIEVED16.3 ± 6.815.3 ± 6.50.228HOSPITALIZATION (%)1.74.60.167MODERATE OHSS (%)1.75.50.091SEVERE OHSS (%)0.00.90.294TOTAL OHSS (%)1.76.50.050*PREGNANCY (%)49.649.80.973* statistically significant Open table in a new tab * statistically significant ConclusionCabergoline administration did not affect the rate of hospital admissions or severe OHSS, however, did significantly reduce the total number of OHSS cases. In addition, using cabergoline did not affect overall clinical pregnancy rate. The overall incidence of OHSS is very low and despite the large numbers of treated subjects, a larger study may be necessary to generate sufficient power to accurately assess efficacy. Cabergoline administration did not affect the rate of hospital admissions or severe OHSS, however, did significantly reduce the total number of OHSS cases. In addition, using cabergoline did not affect overall clinical pregnancy rate. The overall incidence of OHSS is very low and despite the large numbers of treated subjects, a larger study may be necessary to generate sufficient power to accurately assess efficacy.