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. 2015 Jul;20(7):692-6.
doi: 10.4103/1735-1995.166228.

Evaluation of intravenous hydroxylethyl starch, intravenous albumin 20%, and oral cabergoline for prevention of ovarian hyperstimulation syndrome in patients undergoing ovulation induction

Ataollah Ghahiri  1 , Neda Mogharehabed  1 , Minoo Movahedi  1 , Naeimehossadat Hosseini  2
Affiliations

Evaluation of intravenous hydroxylethyl starch, intravenous albumin 20%, and oral cabergoline for prevention of ovarian hyperstimulation syndrome in patients undergoing ovulation induction

Ataollah Ghahiri et al. J Res Med Sci. 2015 Jul.

Abstract

Background: The purpose of this study was to compare the three different strategies, intravenous (IV) hydroxylethyl starch (HES), IV human albumin (HA), and oral Cabergoline (Cb) in the prevention of ovarian hyperstimulation syndrome (OHSS).

Materials and methods: In this prospective randomized clinical trial, 91 women at high risk of developing OHSS were allocated into the three groups, group one received 2 vial (2 × 50 ml) IV HAs, in group two, 1000 ml of 6% HES was administered IV, both groups 30 min after oocyte retrieval within 4 h. Group three, 31 infertile patients received oral Cb 0.5 mg daily for 7 days after oocyte retrieval. Patients were visited 14 ± 1 days after in-vitro fertilization and if β-human chorionic gonadotropin level >10, transvaginal ultrasonography was performed 2 weeks later to confirm intrauterine pregnancy. Patients were followed up weekly for 3 months for signs of OHSS and were also informed about the signs of OHSS and asked to contact immediately if any symptoms of were detected.

Results: None of the participants in group HES developed severe OHSS and only 3 patients (10%) developed mild to moderate OHSS. The incident of severe OHSS was significantly higher in albumin group compared to Cb and HES group (P = 0.033 and P < 0.001, respectively). Also, the probability of developing severe OHSS was higher in Cb group than group HES (P = 0.031).

Conclusion: The findings from this study suggest that administration of 1000 ml of HES 6% has a higher prophylactic effect compared to administration of IV HA and oral Cb.

Keywords: Cabergoline; human albumin; hydroxylethyl starch; ovarian hyperstimulation syndrome; ovarian induction.

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Figures

Figure 1
Figure 1
Frequency of mild, moderate, and severe ovarian hyperstimulation syndrome in three groups of study. HES: Hydroxyl ethyl starch. a: Difference between cabergoline and albumin groups, P = 0.033. b: Difference between albumin and hydroxyl ethyl starch groups, P < 0.001. c: Difference between cabergoline and hydroxyl ethyl starch groups, P = 0.031
See this image and copyright information in PMC

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