Comparison of coasting with Cabergoline administration for prevention of early severe OHSS in ART cycles

Background: One of the major and life-threatening side effects of Assisted Reproductive Technique (ART) is ovarian hyperstimulation syndrome (OHSS). The available data however, have been showed that both Cabergoline (anti VEGF) and coasting reduce the severity of OHSS. Objective: We aimed to compare coasting and Cabergoline administration in prevention of severe OHSS. Materials and Methods: A total of 60 IVF/ICSI cycles were selected. Patients at risk of developing OHSS were divided into two groups as patient's convenience. For 30 patients in coasting group, exogenous gonadotropins were withheld to allow E2 to decrease while GnRH-a was maintained. Then 10,000 unit hCG was administrated and oocyte retrieval was performed 36 hours later. In Cabergoline group, 30 patients were administered with 0.5mg Cabergoline tablet on day of hCG injection, continued for 8 days. Results: The mean number of retrieved, good quality, mature oocytes and the mean number of embryos were significantly different in two groups (p<0.05). The clinical pregnancy rate was 13.3% in coasting and 26.7% in Cabergoline group that was not significantly different (p>0.05). The incidence of severe OHSS was similar in two groups. Conclusion: The Cabergoline was as effective as coasting in the prevention of early severe OHSS in high risk patients, but yielded more retrieved oocytes.