Dopamine agonists in prevention of ovarian hyperstimulation syndrome

Area of Science:

• Reproductive Endocrinology
• Pharmacology
• Obstetrics & Gynecology

Background:

• Ovarian hyperstimulation syndrome (OHSS) is a potential complication of assisted reproductive technologies.
• Dopamine agonists are frequently used to prevent OHSS, but optimal regimens vary.
• Existing literature shows inconsistent findings regarding the efficacy of different dopamine agonists and protocols.

Purpose of the Study:

• To review and analyze the effectiveness of various dopamine agonists in preventing OHSS.
• To identify optimal timing, dosage, and duration for dopamine agonist therapy in OHSS prevention.
• To evaluate the efficacy of dopamine agonists for early-onset versus late-onset OHSS.

Main Methods:

• Systematic review of clinical trials investigating dopamine agonists (cabergoline, quinagolide, bromocriptine) for OHSS prevention.
• Analysis of variations in treatment protocols, including timing, dosage, and duration.
• Comparison of OHSS incidence rates between dopamine agonist groups and placebo groups.

Main Results:

• Dopamine agonists demonstrated significant efficacy in preventing moderate and early-onset OHSS (9.41%) compared to placebo (21.45%).
• Efficacy for preventing late-onset OHSS was not confirmed.
• Optimal regimens identified include 0.5 mg of cabergoline for 8 days or 2.5 mg of rectal bromocriptine for 16 days.

Conclusions:

• Dopamine agonists are effective in preventing early-onset and moderate OHSS.
• Initiating treatment on the day of human chorionic gonadotrophin (hCG) injection or slightly before is recommended.
• Dopamine agonists should be considered for patients at high risk of OHSS or with a history of the syndrome.