How to avoid ovarian hyperstimulation syndrome: a new indication for dopamine agonists

Garcia-Velasco, Juan
April 2009
Reproductive BioMedicine Online (Reproductive Healthcare Limited;2009 Supplement 2, Vol. 18 Issue S2, pS71
Academic Journal
Ovarian hyperstimulation syndrome (OHSS) is the most serious iatrogenic complication associated with ovarian stimulation. Despite the numerous breakthroughs that have been made in other areas of assisted reproduction technology, it is only in recent years that the understanding of OHSS has advanced sufficiently to develop treatment options aimed at reducing the incidence and effects of OHSS. However, suitable predictors and tests with which to identify susceptible patients remain unreliable, although anti-Müllerian hormone is currently a good risk-factor candidate. More progress has been made with the prevention of OHSS, and physicians now have a wide range of treatment options, including coasting, re-initiation of gonadotrophin-releasing hormone (GnRH) antagonist and induction of a luteinizing hormone flare-up using GnRH agonist. Recently, vascular endothelial growth factor (VEGF) has been identified as a key player in the vascular permeability that is associated with OHSS. The use of the dopamine agonist cabergoline has been found to reduce the effects of VEGF-mediated vascular permeability without compromising implantation and pregnancy rates. Together, these treatments will complement the ongoing progress with other procedures such as in-vitro maturation and oocyte vitrification, and enable physicians to improve the prediction and prevention of OHSS.


Related Articles

  • The place of gonadotrophin-releasing hormone antagonists in reproductive medicine. Howles, Colin M. // Reproductive BioMedicine Online (Reproductive Healthcare Limited;Supplement 3, Vol. 4 Issue S3, p64 

    Gonadotrophin-releasing hormone (GnRH) antagonists have recently been introduced into clinical practice. They appear to offer a promising alternative to the long-established GnRH agonist regimens for prevention of a premature LH surge during ovarian stimulation for assisted reproductive...

  • Single dose application of cetrorelix in combination with clomiphene for friendly IVF: results of a feasibility study. Engel, Jorg Bernhard; Olivennes, F; Fanchin, R; Frydman, N; Le Du, A; Blanchet, V; Frydman, R // Reproductive BioMedicine Online (Reproductive Healthcare Limited;Jun2003, Vol. 6 Issue 4, p444 

    Investigates the feasibility of using clomiphene citrate in combination with gonadotrophins, in a luteinizing hormone-releasing hormone (LHRH) antagonist protocol. Role of LHRH antagonist in assisted reproductive technique; Materials and methods used in the study; Results.

  • Direct ovarian effects and safety aspects of GnRH agonists and antagonists. Tarlatzis, B. C.; Kolibianakis, E. M. // Reproductive BioMedicine Online (Reproductive Healthcare Limited;Nov2002 Supplement 1, Vol. 5 Issue S1, p8 

    The wide application of gonadotrophin-releasing hormone (GnRH) analogues in assisted reproduction has raised concerns about their potential extra-pituitary actions. Although data from animal studies support the presence of ovarian GnRH receptors and of direct ovarian effects of GnRH analogues,...

  • Safety aspects of gonadotrophin-releasing hormone antagonists in ovarian stimulation procedures: ovarian hyperstimulation syndrome and health of children born. Ludwig, M.; Katalinic, A.; Felberbaum, R. E.; Diedrich, K. // Reproductive BioMedicine Online (Reproductive Healthcare Limited;Nov2002 Supplement 1, Vol. 5 Issue S1, p61 

    The safety of ovarian stimulation procedures or the procedure of assisted reproduction in general can be estimated by various parameters. Two of the most important are the health of children born after the procedure and the incidence of ovarian hyperstimulation syndrome (OHSS). The latter is...

  • The effect of oral contraceptive pill for cycle scheduling prior to GnRH-antagonist protocol on IVF cycle parameters and pregnancy outcome. Pinkas, Haim; Sapir, Onit; Avrech, Ori M.; Ben-Haroush, Avi; Ashkenzi, Jacob; Fisch, Benjamin; Farhi, Jacob // Journal of Assisted Reproduction & Genetics;Jan2008, Vol. 25 Issue 1, p29 

    Objective To evaluate the effect of oral contraceptive pills (OCP) pretreatment on IVF cycle outcome in GnRH-antagonist protocol. Design Retrospective cohort study. Setting Major tertiary university-affiliated center. Patients All patients treated with GnRH antagonist in our IVF unit during the...

  • Prevention with GnRH Antagonist Treatment.  // Fertility Weekly;3/6/2006, p1 

    The article discusses the study titled "Treatment with the GnRH Antagonist Ganirelix Prevents Premature LH Rises and Luteinization in Stimulated Intrauterine Insemination: Results of a Double-Blind, Placebo-Controlled, Multicentre Trial," by C.B. Lambalk and colleagues published in "Human...

  • Session 40: Female fertility - Clinical aspects 2.  // Human Reproduction;Jul2007 Supplement 1, Vol. 22, pi56 

    The article presents abstracts on the clinical aspects of female fertility, including the practice of embryo donation in French assisted reproductive technology (ART) centres, using three-dimensional (3D) ultrasound in assessing ovarian volume and the temporary suppressive effects of a...

  • Different ART outcomes at increasing peak estradiol levels with long and antagonist protocols: retrospective insights from ten years experience. Manno, Massimo; Cervi, Marta; Zadro, Donatella; Fuggetta, Giuseppa; Adamo, Valter; Tomei, Francesco // Journal of Assisted Reproduction & Genetics;Aug2011, Vol. 28 Issue 8, p693 

    Purpose: To evaluate the impact of high estradiol (E2) levels on assisted reproductive technologies outcomes in high responders (≥12 oocytes retrieved) according to the controlled ovarian stimulation protocol (COS) used. Methods: Clinical retrospective evaluation of total, clinical...

  • GnRH antagonists and endometrial receptivity in oocyte recipients: a prospective randomized trial. Prapas, Nikos; Tavaniotou, Asimina; Panagiotidis, Yannis; Prapa, Stella; Kasapi, Evangelia; Goudakou, Maria; Papatheodorou, Achilleas; Prapas, Yannis // Reproductive BioMedicine Online (Reproductive Healthcare Limited;Feb2009, Vol. 18 Issue 2, p276 

    The effect that gonadotrophin-releasing hormone (GnRH) antagonists exert on endometrial receptivity has not yet been elucidated. GnRH antagonists might directly affect oocytes, the embryo and/or the endometrium. The aim of this study was to investigate the direct effect of GnRH antagonists on...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics