Cabergoline vs intravenous albumin or combination of both for prevention of the early onset ovarian hyperstimulation syndrome

Background: Prophylactic use of dopamine agonist has been associated with a decrease in the severity of ovarian hyperstimulation syndrome (OHSS). Objective: To compare cabergoline with cabergoline plus I.V albumin or I.V albumin alone in prevention of the early onset form of OHSS. Materials and methods: Fifty women at risk of OHSS during IVF/ICSI cycles, having at least 20 follicles in both ovaries and a serum estradiol level >= 3000 pg/ml were selected and divided into three groups. Group I included 15 women started cabergoline (0.25 mg/day for 2-3 day then increased to 0.5 mg/day for 8 days from day of hCG), group II; 15 women were given cabergoline as above plus I.V infusion of 200 ml human albumin 25% at starting of the oocytes retrieval and group III; 20 women were given I.V albumin as above. Results: No women progressed to severe OHSS in group I and II while 2 (10%) women developed severe form in group III. Right mean ovarian diameters were less in group I and II than group III (8.0 +/- 1.5 vs 8.1 +/- 1.3 vs 9.3 +/- 1.2, respectively) P = 0.01. As well as, left mean ovarian diameter (7.9 +/- 1.2 vs 8.0 +/- 1.1 vs 9.0 +/- 1.3, respectively) P = 0.01. Conclusion: Cabergoline alone seems to be effective as cabergoline plus I.V albumin in the prevention of severe early onset form of OHSS in high-risk patients. (C) 2010 Middle East Fertility Society. Production and hosting by Elsevier B.V. All rights reserved.