Objectives: To evaluate outcome of polycystic ovary syndrome (PCOS) women underwent ICSI cycles under cabergoline (Cab) therapy for control of ovarian hyperstimulation syndrome (OHSS) development in comparison to Coasting (Coast) strategy.
Patients & Methods: Women who de-veloped serum estradiol (E2) of >4000 pg/ml and/or sonographic detection of >20 follicles each ≥10 mm in diameter and at least 20% ≥15 mm diameter were divided into two equal groups: Group Cab received cabergoline 0.5 mg daily for 8 days and Group Coast underwent coasting strategy. Evaluat-ed parameters included the frequency and severity of OHSS, clinical preg-nancy rate (CPR).
Results: On day of hCG injection, mean ovarian diameter and serum E2 levels were significantly lower in both Coast and Cab groups compared to at categorization measures with signifi-cant difference in favor of Cab. No patient developed OHSS of more than grade IV, 49 women had OHSS of grades I-II and 15 women of grade III and IV with non-significant difference between both groups. Clinical scorings of OHSS manifestations were signifi-cantly lower with Cab versus Coast-ing. Fifteen patients developed US de-tected ascites and 4 patients had clini-cally detected ascites with significantly lower frequency in Cab group. Three patients required hospitalization; 2 patients for severe distension and one for severe nausea and vomiting. Oo-cyte count, total embryo count and total good embryo count, and fertiliza-tion and clinical pregnancy rates were significantly favorable with Cab.
Conclusion: Both coasting procedure and prophylactic Cab effectively re-duced the incidence and severity of OHSS. Prophylactic Cab provided superior results to Coasting manifest-ed as significant reduction of OHSS severity manifestations with signifi-cant improvement of clinical pregnan-cy rate. |
