Advertisement

Clinical outcome according to timing of cabergoline initiation for prevention of OHSS: a randomized controlled trial

  • Kok-Min Seow
    Affiliations
    Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Please check the insertion of country name in affiliations, and correct if necessary.Taiwan

    Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan
    Search for articles by this author
  • Yu-Hung Lin
    Affiliations
    Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Please check the insertion of country name in affiliations, and correct if necessary.Taiwan

    School of Medicine, Fu-Jen Catholic University, Hsinchuang, Taipei Hsien, Taiwan

    Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan
    Search for articles by this author
  • Chyi-Huey Bai
    Affiliations
    Department of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan
    Search for articles by this author
  • Heng-Ju Chen
    Affiliations
    Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Please check the insertion of country name in affiliations, and correct if necessary.Taiwan

    School of Medicine, Fu-Jen Catholic University, Hsinchuang, Taipei Hsien, Taiwan
    Search for articles by this author
  • Bih-Chwen Hsieh
    Affiliations
    Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Please check the insertion of country name in affiliations, and correct if necessary.Taiwan

    School of Medicine, Fu-Jen Catholic University, Hsinchuang, Taipei Hsien, Taiwan
    Search for articles by this author
  • Lee-Wen Huang
    Affiliations
    Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Please check the insertion of country name in affiliations, and correct if necessary.Taiwan

    School of Medicine, Fu-Jen Catholic University, Hsinchuang, Taipei Hsien, Taiwan
    Search for articles by this author
  • Chii-Ruey Tzeng
    Affiliations
    Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan
    Search for articles by this author
  • Jiann-Loong Hwang
    Correspondence
    Corresponding author.
    Affiliations
    Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Please check the insertion of country name in affiliations, and correct if necessary.Taiwan

    Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan
    Search for articles by this author
Published:March 25, 2013DOI:https://doi.org/10.1016/j.rbmo.2013.03.002

      Abstract

      Cabergoline, a dopamine receptor-2 agonist, is suggested to prevent ovarian hyperstimulation syndrome (OHSS) during ovarian stimulation. The aim of this study was to evaluate the influence of different timing of cabergoline administration on clinical outcome among patients at risk of developing OHSS. Among infertile women undergoing IVF treatment at risk of developing OHSS, 206 were enrolled in this study. The subjects were randomly allocated into two groups, i.e. the study group (n = 100) receiving cabergoline beginning on the day of human chorionic gonadotrophin (HCG) injection and the control group (n = 100) receiving cabergoline starting on the day of oocyte retrieval. Oocyte metaphase-II rate, fertilization rate, clinical outcome and incidence of severe OHSS were compared between the two groups. There were no significant differences in oocyte metaphase-II rate (0.86 ± 0.16 versus 0.85 ± 0.15) or fertilization rate (0.79 ± 0.22 versus 0.76 ± 0.20) or in the incidence of OHSS between two groups. Similarly, there were no significant differences in implantation or clinical pregnancy rate between the two groups. Cabergoline can be administered as soon as HCG injection to prevent early OHSS, without adverse effects on oocyte maturation, fertilization rate and clinical outcome.
      Cabergoline, a dopamine receptor-2 agonist, is suggested to prevent ovarian hyperstimulation syndrome (OHSS) during ovarian stimulation. Nevertheless, the most suitable timing of cabergoline administration has not yet been studied. The aim of this study was to evaluate the influence of different timing of cabergoline administration on final oocyte maturation, fertilization rate and clinical outcome among patients at risk of developing OHSS. Among infertile women undergoing IVF treatment at risk of developing OHSS, 206 were enrolled in this study. The subjects were randomly allocated into two groups, i.e. the study group (n = 100) receiving cabergoline beginning on the day of human chorionic gonadotrophin (HCG) injection and the control group (n = 100) receiving cabergoline starting on the day of oocyte retrieval. Oocyte metaphase II rate, fertilization rate, clinical outcome and incidence of severe OHSS were compared between the two groups. There were no significant differences in oocyte metaphase II rate (0.86 ± 0.16 versus 0.85 ± 0.15) or fertilization rate (0.79 ± 0.22 versus 0.76 ± 0.20) or in the incidence of OHSS (3/100 versus 1/100) between the control and study groups. Similarly, there were no significant differences in implantation rate (36.6% versus 34.0%) or clinical pregnancy rate (54.0% versus 51.0%) between the two groups. Among women at high risk of OHSS, cabergoline can be administered as soon as the HCG injection to prevent early OHSS, without adverse effects on oocyte maturation, fertilization rate and clinical outcome.

      Keywords

      To read this article in full you will need to make a payment

      References

        • Aboulghar M.A.
        • Mansour R.T.
        Ovarian hyperstimulation syndrome: classifications and critical analysis of preventive measures.
        Hum. Reprod. Update. 2003; 9: 275-289
        • Alvarez C.
        • Marti-Bonmati L.
        • Novella-Maestre E.
        • Sanz R.
        • Gomez R.
        • Fernandez-Sanchez M.
        • Simón C.
        • Pellicer A.
        Dopamine agonist cabergoline reduces hemoconcentration and ascites in hyperstimulated women undergoing assisted reproduction.
        J. Clin. Endocrinol. Metab. 2007; 92: 2931-2937
        • Bates D.O.
        • Harper S.J.
        Regulation of vascular permeability by vascular endothelial growth factors.
        Vascul. Pharmacol. 2002; 39: 225-237
        • Cao X.
        • Zhou P.
        • Luo H.
        • Zhao Y.
        • Shi G.
        The effect of VEGF on the temporal-spatial change of alpha-tubulin and cortical granules of ovine oocytes matured in vitro.
        Anim. Reprod. Sci. 2009; 113: 236-250
        • Carizza C.
        • Abdelmassih V.
        • Abdelmassih S.
        • Ravizzini P.
        • Salgueiro L.
        • Salgueiro P.T.
        • Jine L.T.
        • Nagy P.
        • Abdelmassih R.
        Cabergoline reduces the early onset of ovarian hyperstimulation syndrome: a prospective randomized study.
        Reprod. Biomed. Online. 2008; 17: 751-755
        • Delvigne A.
        • Rozenberg S.
        Epidemiology and prevention of ovarian hyperstimulation syndrome (OHSS): a review.
        Hum. Reprod. Update. 2002; 8: 559-577
        • Ebisch I.M.
        • Thomas C.M.
        • Wetzels A.M.
        • Willemsen W.N.
        • Sweep F.C.
        • Steegers-Theunissen R.P.
        Review of the role of the plasminogen activator system and vascular endothelial growth factor in subfertility.
        Fertil. Steril. 2008; 90: 2340-2350
        • Gille H.
        • Kowalski J.
        • Li B.
        • LeCouter J.
        • Moffat B.
        • Zioncheck T.F.
        • Pelletier N.
        • Ferrara N.
        Analysis of biological effects and signaling properties of Flt-1 (VEGFR-1) and KDR (VEGFR-2). A reassessment using novel receptor-specific vascular endothelial growth factor mutants.
        J. Biol. Chem. 2001; 276: 3222-3230
        • Golan A.
        • Ron-el R.
        • Herman A.
        • Soffer Y.
        • Weinraub Z.
        • Caspi E.
        Ovarian hyperstimulation syndrome: an update review.
        Obstet. Gynecol. Surv. 1989; 44: 430-440
        • Gomez R.
        • Simon C.
        • Remohi J.
        • Pellicer A.
        Administration of moderate and high doses of gonadotropins to female rats increases ovarian vascular endothelial growth factor (VEGF) and VEGF receptor-2 expression that is associated to vascular hyperpermeability.
        Biol. Reprod. 2003; 68: 2164-2171
        • Gomez R.
        • Gonzalez-Izquierdo M.
        • Zimmermann R.C.
        • Novella-Maestre E.
        • Alonso-Muriel I.
        • Sanchez-Criado J.
        • Remohi J.
        • Simon C.
        • Pellicer A.
        Low-dose dopamine agonist administration blocks vascular endothelial growth factor (VEGF)-mediated vascular hyperpermeability without altering VEGF receptor 2-dependent luteal angiogenesis in a rat ovarian hyperstimulation model.
        Endocrinology. 2006; 147: 5400-5411
        • Hwang J.L.
        • Seow K.M.
        • Lin Y.H.
        • Hsieh B.C.
        • Huang L.W.
        • Chen H.J.
        • Huang S.C.
        • Chen C.Y.
        • Chen P.H.
        • Tzeng C.R.
        IVF versus ICSI in sibling oocytes from patients with polycystic ovarian syndrome: a randomized controlled trial.
        Hum. Reprod. 2005; 20: 1261-1265
        • Jones B.
        • Jarvis P.
        • Lewis J.A.
        • Ebbutt A.F.
        Trials to assess equivalence: the importance of rigorous methods.
        BMJ. 1996; 313: 36-39
        • Kaczmarek M.M.
        • Schams D.
        • Ziecik A.J.
        Role of vascular endothelial growth factor in ovarian physiology – an overview.
        Reprod. Biol. 2005; 5: 111-136
        • Kaiser U.B.
        The pathogenesis of the ovarian hyperstimulation syndrome.
        N. Engl. J. Med. 2003; 349: 729-732
        • Levinsohn-Tavor O.
        • Friedler S.
        • Schachter M.
        • Raziel A.
        • Strassburger D.
        • Ron-El R.
        Coasting – what is the best formula?.
        Hum. Reprod. 2003; 18: 937-940
        • Lewis J.A.
        Statistical principles for clinical trials (ICH E9): an introductory note on an international guideline.
        Stat. Med. 1999; 18: 1903-1942
        • Lin Y.H.
        • Seow K.M.
        • Hsieh B.C.
        • Huang L.W.
        • Chen H.J.
        • Huang S.C.
        • Chen C.Y.
        • Chen P.H.
        • Hwang J.L.
        • Tzeng C.R.
        Application of GnRH antagonist in combination with clomiphene citrate and hMG for patients with exaggerated ovarian response in previous IVF/ICSI cycles.
        J. Assist. Reprod. Genet. 2007; 24: 331-336
        • Luo H.
        • Kimura K.
        • Aoki M.
        • Hirako M.
        Effect of vascular endothelial growth factor on maturation, fertilization and developmental competence of bovine oocytes.
        J. Vet. Med. Sci. 2002; 64: 803-806
        • Manno M.
        Can we eliminate severe ovarian hyperstimulation syndrome? Comment I.
        Hum. Reprod. 2005; 20 (author reply 2369–2370): 2368-2369
        • Manno M.
        • Tomei F.
        • Marchesan E.
        • Adamo V.
        Cabergoline: a safe, easy, cheap, and effective drug for prevention/treatment of ovarian hyperstimulation syndrome?.
        Eur. J. Obstet. Gynecol. Reprod. Biol. 2005; 122: 127-128
        • Mathur R.S.
        • Akande A.V.
        • Keay S.D.
        • Hunt L.P.
        • Jenkins J.M.
        Distinction between early and late ovarian hyperstimulation syndrome.
        Fertil. Steril. 2000; 73: 901-907
        • McClure N.
        • Healy D.L.
        • Rogers P.A.
        • Sullivan J.
        • Beaton L.
        • Haning Jr, R.V.
        • Connolly D.T.
        • Robertson D.M.
        Vascular endothelial growth factor as capillary permeability agent in ovarian hyperstimulation syndrome.
        Lancet. 1994; 344: 235-236
        • Papanikolaou E.G.
        • Pozzobon C.
        • Kolibianakis E.M.
        • Camus M.
        • Tournaye H.
        • Fatemi H.M.
        • Van Steirteghem A.
        • Devroey P.
        Incidence and prediction of ovarian hyperstimulation syndrome in women undergoing gonadotropin-releasing hormone antagonist in vitro fertilization cycles.
        Fertil. Steril. 2006; 85: 112-120
        • Soares S.R.
        Etiology of OHSS and use of dopamine agonists.
        Fertil. Steril. 2012; 97: 517-522
        • Soares S.R.
        • Gomez R.
        • Simon C.
        • Garcia-Velasco J.A.
        • Pellicer A.
        Targeting the vascular endothelial growth factor system to prevent ovarian hyperstimulation syndrome.
        Hum. Reprod. Update. 2008; 14: 321-333
        • Tang H.
        • Hunter T.
        • Hu Y.
        • Zhai S.D.
        • Sheng X.
        • Hart R.J.
        Cabergoline for preventing ovarian hyperstimulation syndrome.
        Cochrane Database Syst. Rev. 2012; 2: CD008605
        • Van Steirteghem A.C.
        • Nagy Z.
        • Joris H.
        • Liu J.
        • Staessen C.
        • Smitz J.
        • Wisanto A.
        • Devroey P.
        High fertilization and implantation rates after intracytoplasmic sperm injection.
        Hum. Reprod. 1993; 8: 1061-1066
        • Wang T.H.
        • Horng S.G.
        • Chang C.L.
        • Wu H.M.
        • Tsai Y.J.
        • Wang H.S.
        • Soong Y.K.
        Human chorionic gonadotropin-induced ovarian hyperstimulation syndrome is associated with up-regulation of vascular endothelial growth factor.
        J. Clin. Endocrinol. Metab. 2002; 87: 3300-3308
        • Zimmermann R.C.
        • Hartman T.
        • Kavic S.
        • Pauli S.A.
        • Bohlen P.
        • Sauer M.V.
        • Kitajewski J.
        Vascular endothelial growth factor receptor 2-mediated angiogenesis is essential for gonadotropin-dependent follicle development.
        J. Clin. Invest. 2003; 112: 659-669