Preventing ovarian hyperstimulation syndrome: cabergoline versus coasting

Area of Science:

• Reproductive Endocrinology
• Infertility Treatment
• Assisted Reproductive Technology

Background:

• Ovarian hyperstimulation syndrome (OHSS) is a risk in assisted reproductive technology (ART).
• Cabergoline and coasting are established methods for OHSS prevention.
• Comparing their efficacy in moderate-to-severe OHSS is crucial for patient management.

Purpose of the Study:

• To compare the effectiveness of cabergoline versus coasting in preventing moderate-to-severe OHSS.
• To evaluate pregnancy outcomes in patients receiving either cabergoline or coasting for OHSS prevention.

Main Methods:

• A comparative study of 57 infertile patients (81 cycles) at risk for OHSS.
• Inclusion criteria: high E2 levels (>3,500 pg/ml), long GnRH agonist protocol, and use of either cabergoline or coasting.
• Cabergoline group: 0.5 mg daily for 8 days from hCG administration (17 patients/26 cycles).
• Coasting group: withholding gonadotropins (40 patients/55 cycles).

Main Results:

• No significant differences in patient age, BMI, or infertility duration between groups.
• Implantation, clinical pregnancy, and miscarriage rates were similar in both groups.
• Zero cases of OHSS occurred in the cabergoline group compared to 3.6% (2/55 cycles) in the coasting group; this difference was not statistically significant.

Conclusions:

• Daily 0.5 mg cabergoline for 8 days starting on hCG day is highly effective in reducing moderate-to-severe OHSS.
• Cabergoline administration does not compromise pregnancy rates in at-risk patients.
• Cabergoline offers a viable and effective alternative for OHSS prevention in IVF cycles.