Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biol
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Abstrakt

Letrozole and Cabergoline Co-administration in the Early Luteal Phase for Prevention of OHSS in a High Risk Patient Undergoing Ovarian Stimulation for IVF

Fatemi HM, Kyrou D, Papanikolaou EG, Al Buarki H1, Garcia Velasco J

Background: In the face of a high risk for OHSS situation, many strategies have been suggested to prevent it; however, none of the proposed strategies completely prevents OHSS. We report a case of a successful IVF pregnancy and complete prevention of OHSS in a patient at high risk of developing OHSS by co-administration of a dopamine agonist and an aromatase inhibitor during the early luteal phase of the cycle.
Case: A 21-year-old patient with primary infertility, secondary to severe oligoasthenospermia of the male partner was stimulated with rec-FSH/GnRH antagonist protocol. Final oocyte maturation was achieved by administration of 5000 IU of HCG. Due to the high risk of OHSS, patient received directly post oocyte retrieval up to the day of embryo transfer, daily 5 mg Letrozole and 0.5 mg Cabergoline. One embryo was transferred on day 5 post oocyte retrieval.The patient did not develop any early nor late OHSS while a successful ongoing pregnancy was achieved.
Conclusion: Our findings suggest that the use of cabergoline and letrozole in the early luteal phase for the prevention of OHSS, in patients triggered with hCG, might be a potential new strategy. However, their use and effect should be further investigated in prospective randomized studies.