Dopamine agonists for preventing ovarian hyperstimulation syndrome

Abstract

⊕⊝⊝⊝ Very low 1,5 *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

Comparison of the Effectiveness of Various Medicines in the Prevention of Ovarian Hyperstimulation Syndrome: A Network Meta-Analysis of Randomized Controlled Trials

“…This network meta-analysis showed that oral administration of 0.5 mg cabergoline for 8 consecutive days starting from the HCG triggering day was safe and effective in preventing moderate-to-severe OHSS. Consistent with previous meta-analyses, cabergoline prevented moderate-to-severe OHSS and did not affect the clinical pregnancy rates, miscarriage rates, live birth rates, or multiple birth rates ( 57 ). Cabergoline is a dopamine receptor agonist that selectively binds to dopamine receptors to promote endocytosis of VEGF receptors ( 58 ).…”

Comparison of the Effectiveness of Various Medicines in the Prevention of Ovarian Hyperstimulation Syndrome: A Network Meta-Analysis of Randomized Controlled Trials

“…This network meta-analysis showed that oral administration of 0.5 mg cabergoline for 8 consecutive days starting from the HCG triggering day was safe and effective in preventing moderate-to-severe OHSS. Consistent with previous meta-analyses, cabergoline prevented moderate-to-severe OHSS and did not affect the clinical pregnancy rates, miscarriage rates, live birth rates, or multiple birth rates ( 57 ). Cabergoline is a dopamine receptor agonist that selectively binds to dopamine receptors to promote endocytosis of VEGF receptors ( 58 ).…”

Management of ovarian stimulation for IVF: narrative review of evidence provided for World Health Organization guidance

“…Dopamine agonists were assessed in an updated Cochrane systematic review (Tang et al, 2016), which included 16 RCTs on the use of cabergoline, quinagolide and bromocriptine. There was a beneficial effect of the use of dopamine agonists on the overall incidence of moderate or severe OHSS (OR 0.27, 95% CI 0.19 to 0.39; eight RCTs; 1022 women; moderate quality evidence).…”

Does the timing of cabergoline administration impact rates of ovarian hyperstimulation syndrome?

“…Although we found no improvement in reported discomfort or in the rates of severe OHSS with different timings of cabergoline, this may not be the case in hCG-triggered cycles. Given that the only proposed change to the protocol is the timing of cabergoline initiation, and because multiple studies have shown that earlier cabergoline administration has no negative impact on IVF outcomes [ 7 , 14 , 15 , 17 , 18 ], one could argue that there is no risk, and only potential benefit, to administering cabergoline starting at the time of trigger instead of following oocyte collection to reduce the rate of OHSS in moderate and high-risk patients. As demonstrated in the literature, our Trig group did not seem to have any negative outcomes related to oocyte collection and embryo development when compared to the group that received cabergoline at the time of oocyte collection.…”

Comparison of the Effectiveness of Various Medicines in the Prevention of Ovarian Hyperstimulation Syndrome: A Network Meta-Analysis of Randomized Controlled Trials

“…This network meta-analysis showed that oral administration of 0.5 mg cabergoline for 8 consecutive days starting from the HCG triggering day was safe and effective in preventing moderate-to-severe OHSS. Consistent with previous meta-analyses, cabergoline prevented moderate-to-severe OHSS and did not affect the clinical pregnancy rates, miscarriage rates, live birth rates, or multiple birth rates ( 57 ). Cabergoline is a dopamine receptor agonist that selectively binds to dopamine receptors to promote endocytosis of VEGF receptors ( 58 ).…”

Management of ovarian stimulation for IVF: narrative review of evidence provided for World Health Organization guidance

“…Dopamine agonists were assessed in an updated Cochrane systematic review (Tang et al, 2016), which included 16 RCTs on the use of cabergoline, quinagolide and bromocriptine. There was a beneficial effect of the use of dopamine agonists on the overall incidence of moderate or severe OHSS (OR 0.27, 95% CI 0.19 to 0.39; eight RCTs; 1022 women; moderate quality evidence).…”

Does the timing of cabergoline administration impact rates of ovarian hyperstimulation syndrome?

“…Although we found no improvement in reported discomfort or in the rates of severe OHSS with different timings of cabergoline, this may not be the case in hCG-triggered cycles. Given that the only proposed change to the protocol is the timing of cabergoline initiation, and because multiple studies have shown that earlier cabergoline administration has no negative impact on IVF outcomes [ 7 , 14 , 15 , 17 , 18 ], one could argue that there is no risk, and only potential benefit, to administering cabergoline starting at the time of trigger instead of following oocyte collection to reduce the rate of OHSS in moderate and high-risk patients. As demonstrated in the literature, our Trig group did not seem to have any negative outcomes related to oocyte collection and embryo development when compared to the group that received cabergoline at the time of oocyte collection.…”

Comparison of the Effectiveness of Various Medicines in the Prevention of Ovarian Hyperstimulation Syndrome: A Network Meta-Analysis of Randomized Controlled Trials

“…This network meta-analysis showed that oral administration of 0.5 mg cabergoline for 8 consecutive days starting from the HCG triggering day was safe and effective in preventing moderate-to-severe OHSS. Consistent with previous meta-analyses, cabergoline prevented moderate-to-severe OHSS and did not affect the clinical pregnancy rates, miscarriage rates, live birth rates, or multiple birth rates ( 57 ). Cabergoline is a dopamine receptor agonist that selectively binds to dopamine receptors to promote endocytosis of VEGF receptors ( 58 ).…”

Management of ovarian stimulation for IVF: narrative review of evidence provided for World Health Organization guidance

“…Dopamine agonists were assessed in an updated Cochrane systematic review (Tang et al, 2016), which included 16 RCTs on the use of cabergoline, quinagolide and bromocriptine. There was a beneficial effect of the use of dopamine agonists on the overall incidence of moderate or severe OHSS (OR 0.27, 95% CI 0.19 to 0.39; eight RCTs; 1022 women; moderate quality evidence).…”

Does the timing of cabergoline administration impact rates of ovarian hyperstimulation syndrome?

“…Although we found no improvement in reported discomfort or in the rates of severe OHSS with different timings of cabergoline, this may not be the case in hCG-triggered cycles. Given that the only proposed change to the protocol is the timing of cabergoline initiation, and because multiple studies have shown that earlier cabergoline administration has no negative impact on IVF outcomes [ 7 , 14 , 15 , 17 , 18 ], one could argue that there is no risk, and only potential benefit, to administering cabergoline starting at the time of trigger instead of following oocyte collection to reduce the rate of OHSS in moderate and high-risk patients. As demonstrated in the literature, our Trig group did not seem to have any negative outcomes related to oocyte collection and embryo development when compared to the group that received cabergoline at the time of oocyte collection.…”