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Meta-Analysis
. 2021 Apr 14;4(4):CD008605.
doi: 10.1002/14651858.CD008605.pub4.

Dopamine agonists for preventing ovarian hyperstimulation syndrome

Huilin Tang  1 , Selma M Mourad  2 , Aihua Wang  3 , Suo-Di Zhai  4 , Roger J Hart  5
Affiliations
Meta-Analysis

Dopamine agonists for preventing ovarian hyperstimulation syndrome

Huilin Tang et al. Cochrane Database Syst Rev. .

Abstract

Background: Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of ovarian stimulation in assisted reproduction technology (ART). It is characterised by enlarged ovaries and an acute fluid shift from the intravascular space to the third space, resulting in bloating, increased risk of venous thromboembolism, and decreased organ perfusion. Most cases are mild, but forms of moderate or severe OHSS appear in 3% to 8% of in vitro fertilisation (IVF) cycles. Dopamine agonists were introduced as a secondary prevention intervention for OHSS in women at high risk of OHSS undergoing ART treatment. OBJECTIVES: To assess the effectiveness and safety of dopamine agonists in preventing OHSS in women at high risk of developing OHSS when undergoing ART treatment.

Search methods: We searched the following databases from inception to 4 May 2020: Cochrane Gynaecology and Fertility Specialised Register, CENTRAL, MEDLINE, Embase, CINAHL, and PsycINFO for randomised controlled trials (RCTs) assessing the effect of dopamine agonists on OHSS rates. We also handsearched reference lists and grey literature.

Selection criteria: We considered RCTs for inclusion that compared dopamine agonists with placebo/no intervention or another intervention for preventing OHSS in ART. Primary outcome measures were incidence of moderate or severe OHSS and live birth rate. Secondary outcomes were rates of clinical pregnancy, multiple pregnancy, miscarriage, and adverse events.

Data collection and analysis: Two review authors independently screened titles, abstracts, and full texts of publications; selected studies; extracted data; and assessed risk of bias. We resolved disagreements by consensus. We reported pooled results as odds ratios (OR) and 95% confidence interval (CI) by the Mantel-Haenszel method. We applied GRADE criteria to judge overall quality of the evidence.

Main results: The search identified six new RCTs, resulting in 22 included RCTs involving 3171 women at high risk of OHSS for this updated review. The dopamine agonists were cabergoline, quinagolide, and bromocriptine. Dopamine agonists versus placebo or no intervention Dopamine agonists probably lowered the risk of moderate or severe OHSS compared to placebo/no intervention (OR 0.32, 95% CI 0.23 to 0.44; 10 studies, 1202 participants; moderate-quality evidence). This suggests that if the risk of moderate or severe OHSS following placebo/no intervention is assumed to be 27%, the risk following dopamine agonists would be between 8% and 14%. We are uncertain of the effect of dopamine agonists on rates of live birth (OR 0.96, 95% CI 0.60 to 1.55; 3 studies, 362 participants; low-quality evidence). We are also uncertain of the effect of dopamine agonists on clinical pregnancy, multiple pregnancy, miscarriage or adverse events (very low to low-quality evidence). Dopamine agonists plus co-intervention versus co-intervention Dopamine agonist plus co-intervention (hydroxyethyl starch, human albumin, or withholding ovarian stimulation 'coasting') may decrease the risk of moderate or severe OHSS compared to co-intervention (OR 0.48, 95% CI 0.28 to 0.84; 4 studies, 748 participants; low-quality evidence). Dopamine agonists may improve rates of live birth (OR 1.21, 95% CI 0.81 to 1.80; 2 studies, 400 participants; low-quality evidence). Dopamine agonists may improve rates of clinical pregnancy and miscarriage, but we are uncertain if they improve rates of multiple pregnancy or adverse events (very low to low-quality evidence). Dopamine agonists versus other active interventions We are uncertain if cabergoline improves the risk of moderate or severe OHSS compared to human albumin (OR 0.21, 95% CI 0.12 to 0.38; 3 studies, 296 participants; very low-quality evidence), prednisolone (OR 0.27, 95% CI 0.05 to 1.33; 1 study; 150 participants; very low-quality evidence), hydroxyethyl starch (OR 2.69, 95% CI 0.48 to 15.10; 1 study, 61 participants; very low-quality evidence), coasting (OR 0.42, 95% CI 0.18 to 0.95; 3 studies, 320 participants; very low-quality evidence), calcium infusion (OR 1.83, 95% CI 0.88 to 3.81; I² = 81%; 2 studies, 400 participants; very low-quality evidence), or diosmin (OR 2.85, 95% CI 1.35 to 6.00; 1 study, 200 participants; very low-quality evidence). We are uncertain of the effect of dopamine agonists on rates of live birth (OR 1.08, 95% CI 0.73 to 1.59; 2 studies, 430 participants; low-quality evidence). We are uncertain of the effect of dopamine agonists on clinical pregnancy, multiple pregnancy or miscarriage (low to moderate-quality evidence). There were no adverse events reported.

Authors' conclusions: Dopamine agonists probably reduce the incidence of moderate or severe OHSS compared to placebo/no intervention, while we are uncertain of the effect on adverse events and pregnancy outcomes (live birth, clinical pregnancy, miscarriage). Dopamine agonists plus co-intervention may decrease moderate or severe OHSS rates compared to co-intervention only, but we are uncertain whether dopamine agonists affect pregnancy outcomes. When compared to other active interventions, we are uncertain of the effects of dopamine agonists on moderate or severe OHSS and pregnancy outcomes.

Trial registration: ClinicalTrials.gov NCT00329693 NCT01535859 NCT02306564 NCT02134249.

PubMed Disclaimer

Conflict of interest statement

HT: none.

SM: none.

AW: none.

SZ: none.

RH is the Medical Director of Fertility Specialists of Western Australia, has equity interests in and is on the Board of Western IVF, is on the Medical Advisory Boards of MSD, Merck‐Serono and Ferring Pharmaceuticals and in the last two years has received educational grant support from Ferring Pharmaceuticals and in the last five years (other than the last year) has also received travel and accommodation from MSD and Merck Serono.

Figures

1
1
Study flow diagram search May 2020. ART: assisted reproduction technology.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
4
4
Forest plot of comparison 1: Dopamine agonist (without co‐intervention) versus placebo/no intervention, outcome: 1.1 moderate or severe ovarian hyperstimulation syndrome.
5
5
Forest plot of comparison: 2 Dopamine agonist plus co‐intervention versus co‐intervention, outcome: 2.1 Moderate or severe ovarian hyperstimulation syndrome.
6
6
Funnel plot of comparison: 3 Dopamine agonist versus other active interventions, outcome: 3.1 Incidence of moderate or severe ovarian hyperstimulation syndrome (OHSS).
7
7
Forest plot of comparison 3: Cabergoline versus active interventions, outcome: 3.1 moderate or severe ovarian hyperstimulation syndrome.
1.1
1.1. Analysis
Comparison 1: Dopamine agonist versus placebo/no intervention, Outcome 1: Incidence of moderate or severe ovarian hyperstimulation syndrome (OHSS)
1.2
1.2. Analysis
Comparison 1: Dopamine agonist versus placebo/no intervention, Outcome 2: Subgroup analysis by severity of OHSS
1.3
1.3. Analysis
Comparison 1: Dopamine agonist versus placebo/no intervention, Outcome 3: Live birth rate
1.4
1.4. Analysis
Comparison 1: Dopamine agonist versus placebo/no intervention, Outcome 4: Clinical pregnancy rate
1.5
1.5. Analysis
Comparison 1: Dopamine agonist versus placebo/no intervention, Outcome 5: Multiple pregnancy rate
1.6
1.6. Analysis
Comparison 1: Dopamine agonist versus placebo/no intervention, Outcome 6: Miscarriage rate
1.7
1.7. Analysis
Comparison 1: Dopamine agonist versus placebo/no intervention, Outcome 7: Any other adverse events
2.1
2.1. Analysis
Comparison 2: Dopamine agonist plus co‐intervention (DA+co‐int) versus co‐intervention (co‐int), Outcome 1: Incidence of moderate or severe ovarian hyperstimulation syndrome (OHSS)
2.2
2.2. Analysis
Comparison 2: Dopamine agonist plus co‐intervention (DA+co‐int) versus co‐intervention (co‐int), Outcome 2: Live birth rate
2.3
2.3. Analysis
Comparison 2: Dopamine agonist plus co‐intervention (DA+co‐int) versus co‐intervention (co‐int), Outcome 3: Clinical pregnancy rate
2.4
2.4. Analysis
Comparison 2: Dopamine agonist plus co‐intervention (DA+co‐int) versus co‐intervention (co‐int), Outcome 4: Multiple pregnancy rate
2.5
2.5. Analysis
Comparison 2: Dopamine agonist plus co‐intervention (DA+co‐int) versus co‐intervention (co‐int), Outcome 5: Miscarriage rate
2.6
2.6. Analysis
Comparison 2: Dopamine agonist plus co‐intervention (DA+co‐int) versus co‐intervention (co‐int), Outcome 6: Any other adverse events
3.1
3.1. Analysis
Comparison 3: Dopamine agonist versus other active interventions, Outcome 1: Incidence of moderate or severe ovarian hyperstimulation syndrome (OHSS)
3.2
3.2. Analysis
Comparison 3: Dopamine agonist versus other active interventions, Outcome 2: Live birth rate
3.3
3.3. Analysis
Comparison 3: Dopamine agonist versus other active interventions, Outcome 3: Clinical pregnancy rate
3.4
3.4. Analysis
Comparison 3: Dopamine agonist versus other active interventions, Outcome 4: Multiple pregnancy rate
3.5
3.5. Analysis
Comparison 3: Dopamine agonist versus other active interventions, Outcome 5: Miscarriage rate
3.6
3.6. Analysis
Comparison 3: Dopamine agonist versus other active interventions, Outcome 6: Any other adverse events
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Alhalabi 2011 {published and unpublished data}
    1. Alhalabi M, Samawi S, Kafri N, Sharif J, Saker A, Othman A. Role of quinagolide (Norprolac) in preventing ovarian hyperstimulation syndrome (OHSS) in high risk intracytoplasmic sperm injection (ICSI) patients. Fertility and Sterility 2010;98(3 Suppl 1):S103.
    1. Alhalabi M, Samawi S, Taha A, Kafri N, Modi S, Khatib A. Quinagolide reduces OHSS in high risk ICSI patients. Human Reproduction 2011;26(Suppl 1):P-508.
    1. El-Shaer H, Fouda U, Hanafy A, Nabil H, Mehrem W. Cabergoline versus calcium gluconate infusion in the prevention of ovarian hyperstimulation syndrome. A randomized controlled trial. Human Reproduction 2019;34(1):i74.
Alvarez 2007a {published data only}
    1. Alvarez C, Bosch E, Melo MA, Fernandez-Sanches M, Munoz EA, Remohi J, et al. The dopamine agonist cabergoline prevents moderate-severe early ovarian hyperstimulation syndrome (OHSS) in high-risk ART patients. Human Reproduction 2006;21:i96.
    1. Alvarez C, Martí-Bonmatí L, Novella-Maestre E, Sanz R, Gómez R, Fernández-Sánchez M, et al. Dopamine agonist cabergoline reduces hemoconcentration and ascites in hyperstimulated women undergoing assisted reproduction. Journal of Clinical Endocrinology and Metabolism 2007;92:2931-7. - PubMed
Amir 2015 {published and unpublished data}
    1. Amir H, Yaniv D, Hasson J, Amit A, Gordon D, Azem F. Cabergoline for reducing ovarian hyperstimulation syndrome in assisted reproductive technology treatment cycles. A prospective randomized controlled trial. Journal of Reproductive Medicine 2015;60(1-2):48-54. - PubMed
    1. Amir H, Yaniv Kovalski D, Amit A, Azem F. Can dopamine agonist cabergoline reduce ovarian hyperstimulation syndrome in ART treatment cycles? A prospective randomized study. Fertility and Sterility 2011;95(4):S84.
Bassiouny 2018 {published data only}
    1. Bassiouny Yasmin A, Dakhly Dina MR, Bayoumi Yomna A, Salaheldin Noha M, Gouda Hisham M, Hassan Ayman A. Randomized trial of combined cabergoline and coasting in preventing ovarian hyperstimulation syndrome during in vitro fertilization/intracytoplasmic sperm injection cycles. International Journal of Gynaecology and Obstetrics 2018;140(2):217-22. - PubMed
Beltrame 2013 {published and unpublished data}
    1. Beltrame AL, Serafini P, Motta EL, Soares JM Jr, Baracat EC. The effects of bromocriptine on VEGF, kidney function and ovarian hyperstimulation syndrome in in vitro fertilization patients: a pilot study. Gynecological Endocrinology 2013;29(3):201-4. - PubMed
Busso 2010 {published data only}
    1. Busso C, Fernandez-Sanchez M, Garcia-Velasco JA, Landeras J, Ballesteros A, Munoz E, et al. The non-ergot derived dopamine agonist quinagolide in prevention of early ovarian hyperstimulation syndrome in IVF patients: a randomized, double-blind, placebo-controlled trial. Human Reproduction 2010;25(4):995-1004. - PMC - PubMed
Carizza 2008 {published data only}
    1. Carizza C, Abdelmassih V, Abdelmassih S, Ravizzini P, Salgueiro L, Salgueiro PT, et al. Cabergoline reduces the early onset of ovarian hyperstimulation syndrome: a prospective randomized study. Reproductive Biomedicine Online 2008;17:751-5. - PubMed
    1. Carizza C, Abdelmassih V, Ravizzini PC, Salgueiro LL. Ongoing clinical pregnancy is not affected by cabergoline use in women undergoing ICSI with estradiol levels beyond 4000 pg/ml on the day of the hCG. Human Reproduction 2008;23(Suppl 1):i141.
Dalal 2014 {published and unpublished data}
    1. Dalal R, Mishra A. Comparison of coasting with cabergoline administration for prevention of early severe OHSS. BJOG 2014;121:78.
Elnory 2018 {published data only}
    1. Elnory MA, Elmantwe AN. Comparison of cabergoline versus calcium infusion in ovarian hyperstimulation syndrome prevention: a randomized clinical trial. Middle East Fertility Society Journal 2018;23(4):357-62.
El‐Shaer 2019 {unpublished data only}
    1. El-Shaer H, Fouda U, Youssef G, Hanafy A, Nabil H, Mehrem W. Cabergoline versus calcium gluconate infusion in the prevention of ovarian hyperstimulation syndrome. A randomized controlled trial. Human Reproduction 2019;34:i74.
Fetisova 2014 {published and unpublished data}
    1. Fetisova S, Korneeva I, Saroyan T, Krechetova L, Ivanets T. Effects of cabergoline administration for the prevention of OHSS upon the levels of VEGF, VEGFR-1 and VEGFR-2 in high risk IVF/ICSI patients. Human Reproduction 2014;29(Suppl 1):P-482.
Ghahiri 2015 {published data only}
    1. Ghahiri A, Mogharehabed N, Hosseini N. Evaluation of intravenous hydroxyethyl starch, intravenous albumin 20% and oral cabergoline for prevention of ovarian hyperstimulation syndrome in patients undergoing ovulation induction. Journal of Research in Medical Sciences 2015;20(7):693-6. - PMC - PubMed
    1. Ghahiri A, Mogharehabed N, Hosseini N. Evaluation of three different strategies (intravenous hydroxyl ethyl starch, intravenous albumin 20%, and oral cabergoline) for prevention of ovarian hyperstimulation syndrome in patients undergoing ovulation induction. Iranian Journal of Reproductive Medicine 2014;12(6):4.
Jellad 2017 {published data only}
    1. Jellad S, Haj Hassine A, Basly M, Mrabet A, Chibani M, Rachdi R. Vascular endothelial growth factor antagonist reduces the early onset and the severity of ovarian hyperstimulation syndrome. Journal de Gynécologie, Obstétrique et Biologie de la Reproduction 2017;46(1):87-91. - PubMed
Kilic 2015 {published data only}
    1. Kilic N, Ozdemir O, Basar HC, Demircan F, Ekmez F, Yucel O. Cabergoline for preventing ovarian hyperstimulation syndrome in women at risk undergoing in vitro fertilization/intracytoplasmic sperm injection treatment cycles: a randomized controlled study. Avicenna Journal of Medicine 2015;5:123-7. - PMC - PubMed
Matorras 2013 {published and unpublished data}
    1. Matorras R, Andres M, Mendoza R, Prieto B, Pijoan JI, Exposito A. Prevention of ovarian hyperstimulation syndrome in GnRH agonist IVF cycles in moderate risk patients: randomized study comparing hydroxyethyl starch versus cabergoline and hydroxyethyl starch. European Journal of Obstetrics and Gynecology and Reproductive Biology 2013;170(2):439-43. - PubMed
Saad 2017 {published data only}
    1. Saad AS, Mohamed KA. Diosmin versus cabergoline for prevention of ovarian hyperstimulation syndrome. Middle East Fertility Society Journal 2017;22(3):206-10.
Salah 2012 {published data only}
    1. Salah AM, EI-Helew Y. Can cabergoline prevent ovarian hyperstimulation syndrome in polycystic ovarian patients undergoing gonadotropin stimulation? Evidence Based Women's Health Journal 2012;2(2):56-9.
    1. Salah Edeen AM, Alhelou YM. Can cabergoline prevent ovarian hyperstimulation syndrome in PCO patients undergoing gonadotropin stimulation? Comparative study with prednisolone. Human Reproduction 2009;24(1):i60.
Shaltout 2012 {published data only}
    1. Shaltout A, Shohayeb A, Eid M. Role of cabergoline in preventing ovarian hyperstimulation syndrome in high risk intracytoplasmic sperm injection (ICSI) patients and effect on outcome. Human Reproduction 2009;24(Suppl 1):O-154.
    1. Shaltout A, Shohayeb A, Youssef MA. Can dopamine agonist at a low dose reduce ovarian hyperstimulation syndrome in women at risk undergoing ICSI treatment cycles? A randomized controlled study. European Journal of Obstetrics, Gynecology, and Reproductive Biology 2012;165(2):254-8. - PubMed
Singh 2017 {published data only}
    1. Singh S, Raman AK, Ramakrishnan S, Mohamed Ashraf C. Efficacy of cabergoline in the prevention of ovarian hyperstimulation syndrome: a randomized, double-blind and placebo-controlled trial. International Journal of Infertility and Fetal Medicine 2017;8(2):54-60.
Sohrabvand 2009 {published data only}
    1. Sohrabvand F, Ansaripour S, Bagheri M, Shariat M, Jafarabadi M. 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 2009;3(1):35-40.
Tehraninejad 2012 {published data only}
    1. Tehraninejad ES, Hafezi M, Arabipoor A, Aziminekoo E, Chehrazi M, Bahmanabadi A. Comparison of cabergoline and intravenous albumin in the prevention of ovarian hyperstimulation syndrome: a randomized clinical trial. Journal of Assisted Reproduction and Genetics 2012;29(3):259-64. - PMC - PubMed
Torabizadeh 2013 {published and unpublished data}
    1. Torabizadeh A, Vahidroodsari F, Ghorbanpour Z. Comparison of albumin and cabergoline in the prevention of ovarian hyperstimulation syndrome: a clinical trial study. Iranian Journal of Reproductive Medicine 2013;11(10):837-42. - PMC - PubMed

References to studies excluded from this review

Aflatoonian 2008 {published and unpublished data}
    1. Aflatoonian A, Ghandi S, Tabibnejad N. Comparison of coasting with cabergoline administration for prevention of early severe OHSS in ART cycles. Iranian Journal of Reproductive Medicine 2008;6(2):51-5.
Agha Hosseini 2010 {published and unpublished data}
    1. Agha Hosseini M, Aleyasin A, Mahdavi A, Nezami R, Safdarian L, Fallahi P. Cabergoline for prevention of ovarian hyperstimulation syndrome in high risk patients. Iranian Journal of reproductive Medicine 2010;8:70. - PMC - PubMed
Alvarez 2007b {published data only}
    1. Alvarez C, Alonso-Muriel I, Garcia G, Crespo J, Bellver J, Simon C, et al. 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. Journal of Clinical Endocrinology and Metabolism 2007;22:3210-4. - PubMed
Ata 2009 {published data only}
    1. Ata B, Seyhan A, Orhaner S, Urman B. High dose cabergoline in management of ovarian hyperstimulation syndrome. Fertility and Sterility 2009;92(3):1168.e1-4. - PubMed
Fouda 2016 {published and unpublished data}
    1. Fouda UM, Sayed AM, Elshaer HS, Hammad BE, Shaban MM, Elsetohy KA, et al. GnRH antagonist rescue protocol combined with cabergoline versus cabergoline alone in the prevention of ovarian hyperstimulation syndrome: a randomized controlled trial. Journal of Ovarian Research 2016;9(1):29. - PMC - PubMed
Ghaebi 2016 {published data only}
    1. Ghaebi NK, Amirian M, Zarmehri B, Zabihi H. Comparison of the effect of letrozole versus cabergoline for prevention of ovarian hyperstimulation syndrome (OHSS) in patients under ovulation induction treatments and IVF cycles. Iranian Journal of Obstetrics, Gynecology and Infertility 2016;18(184):1-8.
Gualtieri 2011 {published data only}
    1. Gualtieri M, Hoffman D, Barrionuevo M, Christie D, Mouhayar Y, Ory SJ. The effects of cabergoline on ovarian hyperstimulation syndrome (OHSS) and pregnancy outcomes on in vitro fertilization (IVF) patients. Fertility and Sterility 2011;95(4):S259-60.
Guvendag 2010 {published data only}
    1. Guvendag GE, Dilbaz S, Cinar O, Ozdegirmenci O, Aydin S. The effect of cabergoline on follicular microenvironment profile in patients with high risk of OHSS. Fertility and Sterility 2010;94(4):S180-1.
Hatton 2012 {published data only}
    1. Hatton A, Parry S, Hughes G, Wallbutton S, Binnersley S, Lavender A, et al. Cabergoline does not appear to affect pregnancy rates in patients undergoing assisted reproduction. Human Fertility 2012;15(s1):16.
Hosseini 2011 {published data only}
    1. Hosseini MA, Aleyasin A, Mahdavi A, Nezami R, Safdarian L, Fallahi P. The effectiveness of cabergoline for the prevention of ovarian hyperstimulation syndrome. Iranian Journal of Medical Science 2011;36(3):207-12. - PMC - PubMed
Khan 2010 {published data only}
    1. Khan Z, Rollene N, Amols M, Gada R, Coddington C. Cabergoline and ganirelix therapy for early moderate to severe ovarian hyperstimulation syndrome (OHSS) results in faster recovery than in early untreated OHSS. Fertility and Sterility 2010;93(5):S14.
Naredi 2013 {published and unpublished data}
    1. Naredi N, Karunakaran S. Calcium gluconate infusion is as effective as the vascular endothelial growth factor antagonist cabergoline for the prevention of ovarian hyperstimulation syndrome. Journal of Human Reproductive Sciences 2013;6(4):248-52. - PMC - PubMed
Rollene 2009a {published data only}
    1. Rollene NL, Amols MH, Hudson SB, Coddington CC. Treatment of ovarian hyperstimulation syndrome using a dopamine agonist and gonadotropin releasing hormone antagonist: a case series. Fertility and Sterility 2009;92(3):1169.e15-7. - PubMed
Rollene 2009b {published data only}
    1. Rollene NL, Amols MH, Hudson SB, Jensen JR, Morbeck DE, Coddington CC. Cabergoline and ganirelix treatment of ovarian hyperstimulation syndrome (OHSS) results in rapid clinical improvement. Fertility and Sterility 2009;92(3):S240-1. - PubMed
Saad 2016 {published data only}
    1. Saad AS, Mohamed KA, Saad SA. Calcium dobesilate versus cabergoline for prevention of ovarian hyperstimulation syndrome. Human Reproduction 2016;31(Supp 1):P-580.
Saad 2019 {published data only}
    1. Saad A, Eissa S, Abdellateef W. Diosmin addition to cabergoline for the prevention of OHSS, will it differ? A pilot study. BJOG 2019;126:200.
Seow 2013 {published and unpublished data}
    1. Seow KM, Lin YH, Bai CH, Chen HJ, Hsieh BC, Huang LW, et al. Clinical outcome according to timing of cabergoline initiation for prevention of OHSS: a randomized controlled trial. Reproductive Biomedicine Online 2013;26(6):562-8. - PubMed
Seyam 2018 {published data only}
    1. Seyam E, Hefzy E. Laparoscopic ovarian drilling versus GnRH antagonist combined with cabergoline as a prophylaxis against the re-development of ovarian hyperstimulation syndrome. Gynecological Endocrinology 2018;34(7):616-22. - PubMed
Sherwal 2010 {published data only}
    1. Sherwal V, Malik S, Bhatia V. Effect of bromocriptine on the severity of ovarian hyperstimulation syndrome and outcome in high responders undergoing assisted reproduction. Journal of Human Reproductive Sciences 2010;3(2):85-90. - PMC - PubMed
Soliman 2011 {published data only}
    1. Soliman BS. Cabergoline vs intravenous albumin or combination of both for prevention of the early onset ovarian hyperstimulation syndrome. Middle East Fertility Society Journal 2011;16(1):56-60.
Spitzer 2011 {published data only}
    1. Spitzer D, Wogatzky J, Murtinger M, Zech MH, Haidbauer R, Zech NH. Dopamine agonist bromocriptine for the prevention of ovarian hyperstimulation syndrome. Fertility and Sterility 2011;95(8):2742-4.e1. - PubMed
Zahran 2018 {published data only}
    1. Zahran KM, Mostafa WA, Abbas AM, Khalifa MA, Sayed GH. Clomiphene citrate plus cabergoline versus clomiphene citrate for induction of ovulation in infertile euprolactinemic patients with polycystic ovary syndrome: a randomized clinical trial. Middle East Fertility Society Journal 2018;23(3):173-7.
Zargar 2011 {published data only}
    1. Zargar M, Nikbakht R, Pourmatroud E, Ghasemi K, Hemadi M. Comparison of the clinical efficacy of two different cabergoline regimens on prevention of ovarian hyperstimulation syndrome (OHSS). Research Journal of Obstetrics and Gynecology 2011;4(2):51-8.

References to studies awaiting assessment

Ahmadi 2010 {published data only}
    1. Ahmadi S, Rahmani E, Oskouian H. Cabergoline versus human albumin in prophylaxis of ovarian hyperstimulation syndrome. Reproductive Biomedicine Online 2010;20:S41.
    1. Ahmadi SH, Rahmani E, Oskouian H. Cabergoline versus human albumin in prophylaxis of ovarian hyperstimulation syndrome. Iranian Journal of Reproductive Medicine 2011;9(Suppl 1):6 Abstract O-13.

References to ongoing studies

El Khattan 2015 {published and unpublished data}
    1. Comparative study between cabergoline and intravenous calcium in the prevention of ovarian hyperstimulation in women with polycystic ovarian disease undergoing intracytoplasmic sperm injection (ICSI). Ongoing study. July 2013. Contact author for more information.
Hendricks 2015 {published and unpublished data}
    1. Study of cabergoline for prevention of ovarian hyperstimulation syndrome (OHSS) in in vitro fertilization cycles and derivation of OHSS biomarkers. Ongoing study. 15 February 2012. Contact author for more information.
IRCT2016071428930N1 {unpublished data only}
    1. Effects of calcium in the prevention of ovarian hyperstimulation syndrome in patients undergoing IVF/ICSI. Ongoing study. 1 April 2016. Contact author for more information.
Kamel 2015 {published and unpublished data}
    1. Effect of cabergoline on endometrial vascularity during intracytoplasmic sperm injection. Ongoing study. December 2014. Contact author for more information.
Khaled 2014 {unpublished data only}
    1. Diosmin versus cabergoline for prevention of ovarian hyperstimulation syndrome (infertility). Ongoing study. May 2014. Contact author for more information.

Additional references

Aboulghar 2003
    1. Aboulghar MA, Mansour RT. Ovarian hyperstimulation syndrome: classifications and critical analysis of preventive measures. Human Reproduction Update 2003;9(3):275-89. - PubMed
Aboulghar 2009
    1. Aboulghar M. Symposium: update on prediction and management of OHSS – prevention of OHSS. Reproductive Biomedicine Online 2009;19(1):33-42. - PubMed
Al‐Inany 2011
    1. Al-Inany H, Youssef M, Aboulghar M, Broekmans F, Sterrenburg M, Smit J, et al. Gonadotrophin-releasing hormone antagonists for assisted reproductive technology. Cochrane Database of Systematic Reviews 2011, Issue 5. Art. No: CD001750. [DOI: 10.1002/14651858.CD001750.pub3] - DOI - PubMed
Baumgarten 2013
    1. Baumgarten M, Polanski L, Campbell B, Raine-Fenning N. Do dopamine agonists prevent or reduce the severity of ovarian hyperstimulation syndrome in women undergoing assisted reproduction? A systematic review and meta-analysis. Human Fertility (Cambridge) 2013;16(3):168-74. - PubMed
Budayr 2020
    1. Budayr A, Tan TC, Lo JC, Zaroff JG, Tabada GH, Yang J, et al. Cardiac valvular abnormalities associated with use and cumulative exposure of cabergoline for hyperprolactinemia: the CATCH study. BMC Endocrine Disorders 2020;20:25. - PMC - PubMed
Busso 2009
    1. Busso CE, Garcia-Velasco J, Gomez R, Alvarez C, Simon C, Pellicer A. Symposium: update on prediction and management of OHSS: prevention of OHSS – dopamine agonists. Reproductive Biomedicine Online 2009;19(1):43-51. - PubMed
Casper 2015
    1. Casper RF. Reducing the risk of OHSS by GnRH agonist triggering. Journal of Clinical Endocrinology and Metabolism 2015;100(12):4396-8. - PubMed
Castelo‐Branco 2009
    1. Castelo-Branco C, Del Pino M, Valladares E. Ovarian hyperstimulation, hyperprolactinaemia and LH gonadotroph adenoma. Reproductive Biomedicine Online 2009;19(2):153-5. - PubMed
CGF
    1. Cochrane Gynaecology and Fertility Group. CGF guidance for writing all sections of systematic reviews. https://cgf.cochrane.org/sites/cgf.cochrane.org/files/public/uploads/cgf... (accessed 9 March 2021).
Costello 2012
    1. Costello MF, Misso ML, Wong J, Hart R, Rombauts L, Melder A, et al. Treatment of infertility in polycystic ovary syndrome: a brief update. Australian & New Zealand Journal of Obstetrics & Gynaecology 2012;52(4):400-3. - PubMed
D'Angelo 2007
    1. D'Angelo A, Amso NN. Embryo freezing for preventing ovarian hyperstimulation syndrome. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No: CD002806. [DOI: 10.1002/14651858.CD002806.pub2] - DOI - PMC - PubMed
D'Angelo 2017
    1. D'Angelo A, Amso NN, Hassan R. Coasting (withholding gonadotrophins) for preventing ovarian hyperstimulation syndrome. Cochrane Database of Systematic Reviews 2017, Issue 5. Art. No: CD002811. [DOI: 10.1002/14651858.CD002811] - DOI - PMC - PubMed
Delvigne 2002
    1. Delvigne A, Rozenberg S. A qualitative systematic review of coasting, a procedure to avoid ovarian hyperstimulation syndrome in IVF patients. Human Reproduction Update 2002;18(3):291-6. - PubMed
Edwards 2007
    1. Edwards RG. IVF, IVM, natural cycle IVF, minimal stimulation IVF – time for a rethink. Reproductive Biomedicine Online 2007;15(1):106-19. - PubMed
Glade‐Bender 2003
    1. Glade-Bender J, Kandel JJ, Yamashiro DJ. VEGF blocking therapy in the treatment of cancer. Expert Opinion on Biological Therapy 2003;3:263-76. - PubMed
Golan 1989
    1. Golan A, Ron-el R, Herman A, Soffer Y, Weinraub Z, Caspi E. Ovarian hyperstimulation syndrome: an update review. Obstetrical & Gynecological Survey 1989;44(6):430-40. - PubMed
Gómez 2002
    1. Gómez R, Simon C, Remohi J, Pellicer A. Vascular endothelial growth factor receptor-2 activation induces vascular permeability in hyperstimulated rats, and this effect is prevented by receptor blockade. Endocrinology 2002;143:4339-48. - PubMed
Gómez 2006
    1. Gómez R, González-Izquierdo M, Zimmermann RC, Novella-Maestre E, Alonso-Muriel I, Sanchez-Criado J, et al. Low-dose dopamine agonist administration blocks vascular endothelial growth factor (VEGF)-mediated vascular hyperpermeability without altering VEGF receptor 2-dependent luteal angiogenesis in a rat ovarian hyperstimulation model. Endocrinology 2006;147:5400-11. - PubMed
GRADEpro GDT 2015
    1. GRADE Working Group, McMaster University. GRADEpro GDT: GRADEpro Guideline Development Tool [Software]. gradepro.org (accessed 9 October 2020).
Guo 2016
    1. Guo JL, Zhang DD, Zhao Y, Zhang D, Zhang XM, Zhou CQ, et al. Pharmacologic interventions in preventing ovarian hyperstimulation syndrome: a systematic review and network meta-analysis. Scientific Reports 2016;6:19093. - PMC - PubMed
Higgins 2011
    1. Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from training.cochrane.org/handbook/archive/v5.1/.
Higgins 2019
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6 (updated July 2019). Cochrane, 2019. Available from training.cochrane.org/handbook/archive/v6. - PMC - PubMed
Humaidan 2010
    1. Humaidan P, Quartarolo J, Papanikolaou EG. Preventing ovarian hyperstimulation syndrome: guidance for the clinician. Fertility and Sterility 2010;94(2):389-400. - PubMed
Kalampokas 2013
    1. Kalampokas T, Creatsas G, Kalampokas E. Cabergoline as treatment of ovarian hyperstimulation syndrome: a review. Gynecological Endocrinology 2013;29(2):98-100. - PubMed
Kars 2008
    1. Kars M, Delgade V, Holman ER, Feelders RA, Smit JW, Romijn JA, et al. Aortic valve calcification and mild tricuspid regurgitation but no clinical heart disease after 8 years of dopamine agonist therapy for prolactinoma. Journal of Clinical Endocrinology and Metabolism 2008;93(9):3348-56. - PubMed
Kasum 2014
    1. Kasum M, Vrčić H, Stanić P, Ježek D, Orešković S, Beketić-Orešković L, et al. Dopamine agonists in prevention of ovarian hyperstimulation syndrome. Gynecological Endocrinology 2014;30(12):845-9. - PubMed
Knoepfelmacher 2006
    1. Knoepfelmacher M, Danilovic DL, Rosa Nasser RH, Mendonca BB. Effectiveness of treating ovarian hyperstimulation syndrome with cabergoline in two patients with gonadotropin-producing pituitary adenomas. Fertility and Sterility 2006;86(3):719 e15-8. - PubMed
Kuenen 2003
    1. Kuenen BC, Tabernero J, Baselga J, Cavalli F, Pfanner E, Conte PF, et al. Efficacy and toxicity of the angiogenesis inhibitor SU5416 as a single agent in patients with advanced renal cell carcinoma, melanoma, and soft tissue sarcoma. Clinical Cancer Research 2003;9:1648-55. - PubMed
Leitao 2014
    1. Leitao V, Moroni R, Seko L, Nastri C, Martins W. Cabergoline for the prevention of ovarian hyperstimulation syndrome: a systematic review and meta-analysis of randomized controlled trials. Fertility and Sterility 2014;101(3):664-75. - PubMed
Manno 2005
    1. Manno M, Tomei F, Marchesan E, Adamo V. Cabergoline: a safe, easy, cheap, and effective drug for prevention/treatment of ovarian hyperstimulation syndrome? European Journal of Obstetrics, Gynecology, and Reproductive Biology 2005;122(1):127-8. - PubMed
Martin 2009
    1. Martin NM, Tan T, Meeran K. Dopamine agonists and hyperprolactinaemia. BMJ 2009;338:b381. - PubMed
Mathur 2007
    1. Mathur R, Kailasam C, Jenkins J. Review of the evidence base of strategies to prevent ovarian hyperstimulation syndrome. Human Fertility 2007;10(2):75-85. - PubMed
Pauli 2005
    1. Pauli SA, Tang H, Wang J, Bohlen P, Posser R, Hartman T, et al. The vascular endothelial growth factor (VEGF)/VEGF receptor 2 pathway is critical for blood vessel survival in corpora lutea of pregnancy in the rodent. Endocrinology 2005;146:1301. - PubMed
Prakash 2009
    1. Prakash A, Karasu T, Mathur R. Ovarian hyperstimulation syndrome: pathophysiology, prevention and management. Obstetrics, Gynaecology and Reproductive Medicine 2009;19(9):274-52.
Rabau 1967
    1. Rabau E, David A, Serr DM, Mashiach S, Lunenfeld B. Human menopausal gonadotropins for anovulation and sterility. Results of 7 years of treatment. American Journal of Obstetrics and Gynecology 1967;98(1):92-8. - PubMed
RCOG 2006
    1. Royal College of Obstetricians and Gynaecologists (RCOG). The management of ovarian hyperstimulation syndrome. London (UK): Royal College of Obstetricians and Gynaecologists (RCOG). Green-top Guideline No 5 2006.
Review Manager 2014 [Computer program]
    1. Review Manager (RevMan). Version 5.3. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Rockwell 2002
    1. Rockwell LC, Pillai S, Olson CE, Koos RD. Inhibition of vascular endothelial growth factor/vascular permeability factor action blocks estrogen-induced uterine edema and implantation in rodents. Biology of Reproduction 2002;67:1804-10. - PubMed
Schade 2007
    1. Schade R, Andershon S, Suissa S, Haverkamp W, Garbe E. Dopamine agonists and the risk of cardiac-valve regurgitation. New England Journal of Medicine 2007;356:29-38. - PubMed
Soares 2008
    1. Soares SR, Gomez R, Simon C, Garcia-Velasco JA, Pellicer A. Targeting the vascular endothelial growth factor system to prevent ovarian hyperstimulation syndrome. Human Reproduction Update 2008;14(4):321-3. - PubMed
Soares 2012
    1. Soares SR. Etiology of OHSS and use of dopamine agonists. Fertility and Sterility 2012;97(3):517-22. - PubMed
Trifiro 2012
    1. Trifiro G, Mokhles MM, Dieleman JP, Soest EM, Verhamme K, Mazzaglia G, et al. Risk of cardiac valve regurgitation with dopamine agonist use in Parkinson's disease and hyperprolactinaemia: a multi-country, nested case-control study. Drug Safety 2012;35:159-71. - PubMed
Tso 2014
    1. Tso L, Costello M, Albuquerque L, Andriolo R, Macedo C. Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews 2014, Issue 11. Art. No: CD006105. [DOI: 10.1002/14651858.CD006105.pub3] - DOI - PMC - PubMed
van der Linden 2015
    1. Linden M, Buckingham K, Farquhar C, Kremer JA, Metwally M. Luteal phase support for assisted reproduction cycles. Cochrane Database of Systematic Reviews 2015, Issue 7. Art. No: CD009154. [DOI: 10.1002/14651858.CD009154.pub3] - DOI - PMC - PubMed
Vloeberghs 2009
    1. Vloeberghs V, Peeraer K, Pexsters A, D'Hooghe T. Ovarian hyperstimulation syndrome and complications of ART. Best Practice & Research. Clinical Obstetrics & Gynaecology 2009;23(5):691-709. - PubMed
Walls 2012
    1. Walls M, Junk S, Ryan JP, Hart R. IVF versus ICSI for the fertilization of in-vitro matured human oocytes. Reproductive Biomedicine Online 2012;25(6):603-7. - PubMed
Walls 2015
    1. Walls ML, Hunter T, Ryan JP, Keelan JA, Nathan E, Hart RJ. In vitro maturation as an alternative to standard in vitro fertilization for patients diagnosed with polycystic ovaries: a comparative analysis of fresh, frozen and cumulative cycle outcomes. Human Reproduction 2015;30(1):88-96. - PubMed
Youssef 2010
    1. Youssef MA, Wely M, Hassan MA, Al-Inany HG, Mochtar M, Khattab S, et al. Can dopamine agonists reduce the incidence and severity of OHSS in IVF/ICSI treatment cycles? A systematic review and meta-analysis. Human Reproduction Update 2010;16(5):459-66. - PubMed
Youssef 2016
    1. Youssef MA, Mourad S. Volume expanders for the prevention of ovarian hyperstimulation syndrome. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No: CD001302. [DOI: 10.1002/14651858.CD001302] - DOI - PMC - PubMed
Zanettini 2007
    1. Zanettini R, Antonini A, Gatto G, Gentile R, Tesei S, Pezzoli G. Valvular heart disease and the use of dopamine agonists for Parkinson's disease. New England Journal of Medicine 2007;356:39-46. - PubMed

References to other published versions of this review

Tang 2016
    1. Tang H, Mourad S, Zhai SD, Hart RJ. Dopamine agonists for preventing ovarian hyperstimulation syndrome. Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No: CD008605. [DOI: 10.1002/14651858.CD008605.pub3] - DOI - PMC - PubMed

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