Inhibition of cyclooxygenase-2 (COX-2) by meloxicam decreases the incidence of ovarian hyperstimulation syndrome in a rat model

Role of Serum miRNAs in the Prediction of Ovarian Hyperstimulation Syndrome in Polycystic Ovarian Syndrome Patients

“…Recently, VEGF was predicted to be targeted by miR-16, and miR-16 had been verified to modulate angiogenesis by regulating the VEGF-A expression [23]. Taking into consideration the crucial role of VEGF in the increased endothelial/vessel permeability and development of OHSS [24,25,26] and our result which showed lower serum miR-16 levels in PCOS women who develop severe OHSS than in women who develop mild or no OHSS, miR-16 is implicated in the development of OHSS in women with PCOS and VEGF and angiogenesis pathways might be more susceptible in OHSS group than in the control group.…”

Ovarian hyperstimulation syndrome: pathophysiology and prevention

“…After the demonstration of the partial inhibition of ovarian VEGF receptor 2 (VEGFR-2) phosphorylation levels by the dopamine agonist cabergoline in an animal model [35] and its consequent reversion of VEGFR-2 vascular permeability Cabergoline inhibits partially the VEGF receptor 2 phosphorylation levels and associated vascular permeability without affecting luteal angiogenesis [35] Reduction on the 'early'(within the first 9 days after hCG) onset of OHSS [36] Even using cabergoline, the OHSS incidence may be as high as 10.8% [36] Non-steroidal antiinflammatory A large RCT demonstrated that low dose aspirin was associated with reduction in the OHSS incidence (0.25% vs. 8.4%) in a high-risk group with similar pregnancy rates [37] Meloxican was capable of reducing the OHSS associated ovarian weight and expression of VEGF in an animal model [38] GnRH antagonist protocol This regimen is associated with a significant reduction in OHSS (Odds Ratio=0.60) as well as with fewer interventions to prevent OHSS (OR=0.43) However a slight reduction in pregnancy rates was also observed (OR=0.83) [39] Replacement of hCG A single dose of recombinant LH was safer than hCG and was effective in inducing follicular maturation The dosage of 15,000-30,000 IU is still too expensive [42] Using a GnRH agonist to induce final oocyte maturation, no cases of moderate/severe OHSS were observed in 1,152 cycles of oocyte donation against 14 cases in 1,137 cases who received hCG [43,44]. This requires the use of GnRH antagonist protocol.…”

“…The pregnancy rates were similar. Meloxican is another anti-inflammatory drug that was studied in an animal model [38], where it was demonstrated to be capable of reducing the OHSS associated ovarian weight and expression of VEGF.…”

Le syndrome d’hyperstimulation ovarienne : physiopathologie, facteurs de risque, prévention et prise en charge

“…Le Meloxican est un autre anti-inflammatoire qui semble prometteur chez l'animal [169], mais qui reste à évaluer chez l'homme.…”

“…Quelques traitements médicamenteux tels que l'indométhacine, les anti-cox2 [169], la cabergoline (Dostinex ® ) [234], les antihistaminiques et les inhibiteurs de l'enzyme de conversion (IEC) ont été administrés dans des études animales ou dans des études cliniques non randomisées ou rétrospectives. Il n'existe pas, à l'heure actuelle, d'indication fiable de ces molécules dans la prise en charge thérapeutique de ce syndrome en l'absence d'essai randomisé.…”