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Cabergoline administration prevents development of moderate to severe ovarian hyperstimulation syndrome and it contributes to reduction in ovarian volume

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Reproductive Medicine and Biology

Abstract

Purpose

The aim of this study was to determine the prophylactic effects of cabergoline on ovarian hyperstimulation syndrome (OHSS) after oocyte retrieval.

Methods

A total of 187 women underwent controlled ovarian stimulation using gonadotropin releasing hormone (GnRH) agonist long protocol or flexible GnRH antagonist protocol for in vitro fertilization. They responded excessively to ovulation induction, and fresh embryo transfers were canceled. Sixty-one patients in the intervention group were administered oral cabergoline (0.5 mg) three times after oocyte retrieval (day 0, 2, and 4 following the oocyte retrieval). Ultrasonography and blood examination were performed on the seventh day following oocyte retrieval. The main outcomes measured were the incidence of OHSS, estimated ovarian volumes, ascites, hematocrits, and white blood cell counts.

Results

The incidence of moderate to severe OHSS was lower after cabergoline administration (9.8 vs. 23.0 %, p = 0.03). The ovarian volumes reduced after intervention (96.2 vs. 145.5 cm3, p = 0.008). The reduction was evident in the patients with agonist long protocol (92.1 vs. 167.5 cm3, p = 0.0005). No significant differences were observed for other factors.

Conclusions

Cabergoline has a favorable effect on the prevention of moderate to severe OHSS affiliated with ovarian volume reduction.

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References

  1. The practice committee of the American society for reproductive medicine: ovarian hyperstimulation syndrome. Fertil Steril 2008;90:S188–93.

  2. Geva E, Jaffe RB. Role of vascular endothelial growth factor in ovarian physiology and pathology. Fertil Steril. 2000;74:429–38.

    Article  CAS  PubMed  Google Scholar 

  3. Soares SR, Gómez R, Simón C, García-velasco JA, Pellicer A. Targeting the vascular endothelial growth factor system to prevent ovarian hyperstimulation syndrome. Hum Reprod Update. 2008;14:321–33.

    Article  CAS  PubMed  Google Scholar 

  4. Gómez R, Simon C, Remohi J, Pellicer A. Vascular endothelial growth factor receptor-2 activation induces vascular permeability in hyperstimulated rats, and this effect is prevented by receptor blockade. Endocrinology. 2002;143:4339–48.

    Article  PubMed  Google Scholar 

  5. Rizk B, Aboulghar M, Smitz J, Ron-EI R. The role of vascular endothelial growth factor and interleukins in the pathogenesis of severe ovarian hyperstimulation syndrome. Hum Reprod Update. 1997;3:255–66.

    Article  CAS  PubMed  Google Scholar 

  6. Gomez R, Gonzalez-Izquierdo M, Zimmermann RC, Novella-Maestre E, Alonso-Muriel I, Sanchez-Criado J, et al. Low dose dopamine agonist administration blocks VEGF mediated vascular hyperpermeability without altering VEGFR-2 dependent luteal angiogenesis in a rat ovarian hyperstimulation model. Endocrinology. 2006;147:5400–11.

    Article  CAS  PubMed  Google Scholar 

  7. Álvarez C, Martı´-Bonmatı´ L, Novella-Maestre E, Sanz R, Go´mez R, Ferna´ndez-Sa´nchez M, Simo`n C, Pellicer A. Dopamine agonist cabergoline reduces hemoconcentration and ascites in hyperstimulated women undergoing assisted reproduction. J Clin Endocrinol Metab. 2007;92:2931–7.

    Article  PubMed  Google Scholar 

  8. Youssef MA, van Wely M, Hassan MA, Al-Inany G, Mochtar M, Khattab S, et al. Can dopamine agonists reduce the incidence and severity of OHSS in IVF/ICSI treatment cycles? A systematic review and meta-analysis. Hum Reprod Update. 2010;16:459–66.

    Article  CAS  PubMed  Google Scholar 

  9. Irahara M, Kubota T, Ishihara O, Saito H, Mizunuma H, Yano S. Management and prevention of ovarian hyperstimulation syndrome (Japanese). Acta Obstet Gynecol Jpn. 2008;61:1138–45.

    Google Scholar 

  10. Garcia-Velasco JA, Pellicer A. New concepts in the understanding of the ovarian hyperstimulation syndrome. Curr Opin Obstet Gynecol. 2003;15:251–6.

    Article  PubMed  Google Scholar 

  11. Golan A, Ron-El R, Herman A, Soffer Y, Weinraub Z, Caspi E. Ovarian hyperstimulation syndrome: an update review. Obstet Gynecol Sur. 1989;44:430–40.

    Article  CAS  Google Scholar 

  12. Navot D, Bergh PA, Laufer N. Ovarian hyperstimulation syndrome in novel reproductive technologies: prevention and treatment. Fertil Steril. 1992;58:249–61.

    CAS  PubMed  Google Scholar 

  13. Lass A, Brinsden P. The role of ovarian volume in reproductive medicine. Hum Reprod Update. 1999;15:256–66.

    Article  Google Scholar 

  14. Lainas TG, Sfontouris IA, Zorzovilis IZ, Petsas GK, Lainas GT, Alexopoulou E, et al. Flexible GnRH antagonist protocol versus GnRH agonist long protocol in patients with polycystic ovary syndrome treated for IVF: a prospective randomized controlled trial (RCT). Hum Reprod. 2010;25:683–9.

    Article  CAS  PubMed  Google Scholar 

  15. Tang H, Hunter T, Hu Y, Zhai SD, Sheng X, Hart RJ. Cabergoline for preventing ovarian hyperstimulation syndrome. Cochrane Database Syst Rev. 2012;. doi:10.1002/14651858.CD008605.pub2.

    Google Scholar 

  16. Vanrell JA, Balash J. Prolactin in the evaluation of luteal phase in infertility. Fertil Steril. 1983;39:30–3.

    CAS  PubMed  Google Scholar 

  17. Bohnet HG, Muhlenstedt D, Hanker JP, Schneider HP. Prolactin oversuppression. Arch Gynakol. 1977;223:173–8.

    Article  CAS  PubMed  Google Scholar 

  18. Álvarez C, Alonso-Muriel I, García G, Crespo J, Bellver J, Simón C, et al. Implantation is apparently unaffected by the dopamine agonist Cabergoline when administered to prevent ovarian hyperstimulation syndrome in women undergoing assisted reproductive treatment: a pilot study. Hum Reprod. 2007;22:3210–4.

    Article  PubMed  Google Scholar 

  19. Ferrari C, Barbieri C, Caldara R, Mucci M, Codecasa F, Paracchi A, et al. Long-lasting prolactin-lowering effect of cabergoline, a new dopamine agonist, in hyperprolactinemic patients. J Clin Endocrinol Metab. 1986;63:941–5.

    Article  CAS  PubMed  Google Scholar 

  20. Schade R, Andershon S, Suissa S, Haverkamp W, Garbe E. Dopamine agonists and the risk of cardiac-valve regurgitation. N Engl J Med. 2007;356:29–38.

    Article  CAS  PubMed  Google Scholar 

  21. Zanettini R, Antonini A, Gatto G, Gentile R, Tesei S, Pezzoli G. Valvular heart disease and the use of dopamine agonist for Parkinson’s disease. N Engl J Med. 2007;356:39–46.

    Article  CAS  PubMed  Google Scholar 

  22. Carizza C, Abdelmassih V, Abdelmassih S, Ravizzini P, Salgueiro L, Salgueiro PT, et al. Cabergoline reduces the early onset of ovarian hyperstimulation syndrome: a prospective randomized study. Rerprod Biomed Online. 2008;17:751–5.

    Article  CAS  Google Scholar 

  23. Novella-Maestre E, Carda C, Noguera I, Ruiz-Sauri A, García-Velasco JA, Simón C, et al. Dopamine agonist administration causes a reduction in endometrial implants through modulation of angiogenesis in experimentally induced endometriosis. Hum Reprod. 2009;24:1025–35.

    Article  CAS  PubMed  Google Scholar 

  24. Robert E, Musatti L, Piscitelli G. Pregnancy outcome after treatment with the ergot derivative cabergoline. Reprod Toxicol. 1996;10:333–7.

    Article  CAS  PubMed  Google Scholar 

  25. Parazzini FE, Motta T, Ferrari CL, Colao A, Clavenna A, Rocchi F, et al. Pregnancy outcome after cabergoline treatment in early weeks of gestation. Reprod Toxicol. 2002;16:791–3.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank Enago (www.enago.jp) for the English language review.

Conflict of interest

Tomoko Inoue, Shu Hashimoto, Hideyuki Iwahata, Keijiro Ito, Yoshiharu Nakaoka, and Yoshiharu Morimoto declare that they have no conflict of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000(5). Informed consent was obtained from all patients for being included in the study.

Animal studies

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. IVF Namba Clinic, 1-17-28 Minamihorie, Nishi-ku, Osaka, 550-0015, Japan

    Tomoko Inoue, Shu Hashimoto, Hideyuki Iwahata, Keijiro Ito, Yoshiharu Nakaoka & Yoshiharu Morimoto

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  1. Tomoko Inoue
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  2. Shu Hashimoto
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  3. Hideyuki Iwahata
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  6. Yoshiharu Morimoto
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Correspondence to Tomoko Inoue.

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Inoue, T., Hashimoto, S., Iwahata, H. et al. Cabergoline administration prevents development of moderate to severe ovarian hyperstimulation syndrome and it contributes to reduction in ovarian volume. Reprod Med Biol 14, 79–84 (2015). https://doi.org/10.1007/s12522-014-0198-9

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  • DOI: https://doi.org/10.1007/s12522-014-0198-9

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