OJOG  Vol.5 No.6 , June 2015
The Importance of Prolactin Levels in Patients Treated with Cabergoline for the Prevention of OHSS: Is Cabergoline Really Effective in Patients with High Risk of OHSS?
Abstract: Background: OHSS is a dangerous and potentially life-threatening condition for which many researchers look for new ways to treat. Aim: To determine the effectiveness of prophylactic cabergoline administration on prolactine levels in patients with high risk for ovarian hyperstimulation syndrome (OHSS). Material and Methods: 163 in vitro fertilisation (IVF) patients with high risk for OHSS were enrolled in the study. The criteria for inclusion were more than 15 oocytes retrieved at oocyte pick up. A standard antagonist protocol was used for ovulation induction. Cabergoline treatments (0.5 mg/day) were started on the day of oocyte retrieval and continued for eight days. Prolactine levels were measured at the day of oocyte retrieval and the 9th day after the oocyte retrieval. Results: Of the 163 patients, 26 (15.9%) had OHSS. Prolactine levels on the day of oocyte retrieval were 44.22 ± 24.78 ng/mL and 37.6 ± 22.5 ng/mL in patients with OHSS and without OHSS, respectively (P > 0.05). In contrary prolactine levels were significantly higher in patients with OHSS patients (3.9 ± 5.07 ng/mL) than in patients without OHSS (2.1 ± 2.92 ng/mL) at the 9th day after oocyte retrieval (P < 0.05). Conclusion: Prolactine levels were higher in patients with OHSS than without OHSS who were treated with cabergoline for the prevention of OHSS.
Cite this paper: Oral, S. , Akpak, Y. , Karaca, N. and Savan, K. (2015) The Importance of Prolactin Levels in Patients Treated with Cabergoline for the Prevention of OHSS: Is Cabergoline Really Effective in Patients with High Risk of OHSS?. Open Journal of Obstetrics and Gynecology, 5, 344-349. doi: 10.4236/ojog.2015.56050.

[1]   Temel, T., Akpak, Y.K., Gün, I., Oral, S. and Sofuoglu, K. (2015) Impact of Paternal Age on Intracytoplasmic Sperm Injection Cycle Results. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 4, 622-628.

[2]   Mathur, R., Kailasam, C.H. and Jenkins, J. (2007) Review of the Evidence Base of Strategies to Prevent Ovarian Hyper Stimulation Syndrome. Human Fertility, 10, 75-85.

[3]   Aboulghar, M.A. and Mansour, R.T. (2003) Ovarian Hyperstimulation Syndrome: Classifications and Critical Analysis of Preventive Measures. Human Reproduction Update, 9, 275-289.

[4]   Fiedler, K. and Ezcurra, D. (2012) Predicting and Preventing Ovarian Hyperstimulation Syndrome (OHSS): The Need for Individualized Not Standardized Treatment. Reproductive Biology and Endocrinology, 10, 32.

[5]   Saylan, A., Arioz, D.T., Koken, T., Dilek, H., Saylan, F. and Yilmazer, M. (2010) Prevention of Ovarian Hyperstimulation Syndrome in a Rat Model: Efficacy Comparison between Cabergoline and Meloxicam. Acta Obstetricia et Gynecologica Scandinavica, 89, 692-699.

[6]   Wang, T.H., Horng, S.G., Chang, C.L., Wu, H.M., Tsai, Y.J., Wang, H.S. and Soong, Y.K. (2002) Human Chorionic Gonadotropin-Induced Ovarian Hyperstimulation Syndrome Is Associated with Up-Regulation of Vascular Endothelial Growth Factor. Journal of Clinical Endocrinology Metabolism, 87, 3300-3308.

[7]   Pellicer, A., Albert, C., Mercader, A., Bonilla-Musoles, F., Remohí, J. and Simón, C. (1999) The Pathogenesis of Ovarian Hyperstimulation Syndrome: In Vivo Studies Investigating the Role of Interleukin-1beta, Interleukin-6, and Vascular Endothelial Growth Factor. Fertility and Sterility, 71, 482-489.

[8]   Leitao, V.M., Moroni, R.M., Seko, L.M., Nastri, C.O. and Martins, W.P. (2014) Cabergoline for the Prevention of Ovarian Hyperstimulation Syndrome: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Fertility and Sterility, 101, 664-675.

[9]   Gomez, R., Gonzalez-Izquierdo, M., Zimmermann, R.C., Novella-Maestre, E., Alonso-Muriel, I., Sanchez-Criado, J., Remohi, J., Simon, C. and Pellicer, A. (2006) Low-Dose Dopamine Agonist Administration Blocks Vascular Endothelial Growth Factor (VEGF)-Mediated Vascularhyperpermeability without Altering VEGF Receptor 2-Dependent Luteal Angiogenesis in a Rat Ovarianhyperstimulation Model. Endocrinology, 147, 5400-5411.

[10]   Golan, A., Ronel, R., Herman, A., Soffer, Y., Weinraub, Z. and Caspi, E. (1989) Ovarian Hyperstimulation Syndrome: An Update Review. Obstetrical Gynecological Survey, 44, 430-440.

[11]   Tang, H., Hunter, T., Hu, Y., Zhai, S.D., Sheng, X. and Hart, R.J. (2012) Cabergoline for Preventing Ovarian Hyperstimulation Syndrome. Cochrane Database of Systematic Reviews, 2, CD008605.

[12]   Kalampokas, T., Creatsas, G. and Kalampokas, E. (2013) Cabergoline as Treatment of Ovarian Hyperstimulation Syndrome: A Review. Gynecological Endocrinology, 29, 98-100.

[13]   Alvarez, C., Alonso-Muriel, I., García, G., Crespo, J., Bellver, J., Simón, C. and Pellicer, A. (2007) Implantation is Apparently Unaffected by the Dopamine Agonist Cabergoline When Administered to Prevent Ovarian Hyperstimulation Syndrome in Women Undergoing Assisted Reproduction Treatment: A Pilot Study. Human Reproduction, 22, 3210-3214.

[14]   Carizza, C., Abdelmassih, V., Abdelmassih, S., Ravizzini, P., Salgueiro, L., Salgueiro, P.T., Jine, L.T., Nagy, P. and Abdelmassih, R. (2008) Cabergoline Reduces the Early Onset of Ovarian Hyperstimulation Syndrome: A Prospective Randomized Study. Reproductive BioMedicine Online, 17, 751-755.

[15]   Sohrabvand, F., Ansaripour, S., Bagheri, M., Shariat, M. and Jafarabadi, M. (2009) Cabergoline versus Coasting in the Prevention of Ovarian Hyperstimulation Syndrome and Assisted Reproductive Technologies Outcome in High Risk Patients. International Journal of Fertility and Sterility, 3, 35-40.

[16]   Hwang, J.L., Lin, Y.H. and Soew, K.M. (2010) Failure of Cabergoline to Prevent Severe Ovarian Hyperstimulation Syndrome in Patients with Extremely High Estradiol Levels. International Journal of Gynecology & Obstetrics, 108, 159-160.

[17]   Tehraninejad, E.S., Hafezi, M., Arabipoor, A., Aziminekoo, E., Chehrazi, M. and Bahmanabadi, A. (2012) Comparison of Cabergoline and Intravenous Albumin in the Prevention of Ovarian Hyperstimulation Syndrome: A Randomized Clinical Trial. Journal of Assisted Reproduction and Genetics, 29, 259-264.

[18]   Youssef, M.A., van Wely, M., Hassan, M.A., Al-Inany, H.G., Mochtar, M., Khattab, S. and van der Veen, F. (2010) Can Dopamine Agonists Reduce the Incidence and Severity of OHSS in IVF/ICSI Treatment Cycles? A Systematic Review and Meta-Analysis. Human Reproduction Update, 16, 459-466.

[19]   Ata, B., Seyhan, A., Orhaner, S. and Urman, B. (2009) High Dose Cabergoline in Management of Ovarian Hyperstimulation Syndrome. Fertility and Sterility, 92, 1168.e1-1168.e4.

[20]   Seow, K.M., Lin, Y.H., Bai, C.H., Chen, H.J., Hsieh, B.C., Huang, L.W., Tzeng, C.R. and Hwang, J.L. (2013) Clinical Outcome According to Timing of Cabergoline Initiation for Prevention of OHSS: A Randomized Controlled Trial. Reproductive BioMedicine Online, 26, 562-568.

[21]   Novella-Maestre, E., Carda, C., Noguera, I., Ruiz-Saurí, A., García-Velasco, J.A., Simón, C. and Pellicer, A. (2009) Dopamine Agonist Administration Causes a Reduction in Endometrial Implants through Modulation of Angiogenesis in Experimentally Induced Endometriosis. Human Reproduction, 24, 1025-1035.

[22]   Zanettini, R., Antonini, A., Gatto, G., Gentile, R., Tesei, S. and Pezzoli, G. (2007) Valvular Heart Disease and the Use of Dopamine Agonists for Parkinson’s Disease. The New England Journal of Medicine, 356, 39-46.

[23]   Herring, N., Szmigielski, C., Becher, H., Karavitaki, N. and Wass, J.A. (2009) Valvular Heart Disease and the Use of Cabergoline for the Treatment of Prolactinoma. Clinical Endocrinology, 70, 104-108.