title: Can dopamine agonists reduce the incidence and severity of OHSS in IVF/ICSI treatment cycles? A systematic review and meta-analysis.
abstract: BACKGROUND
  Recently, dopamine agonists were proposed as a prophylactic treatment for ovarian hyperstimulation syndrome (OHSS) in women at high risk in IVF/ICSI treatment cycles.
  
  
  METHODS
  We conducted a systematic review and meta-analysis of randomized trials comparing the prophylactic effect of the dopamine agonist, cabergoline, versus no treatment in IVF/ICSI cycles. Primary outcome was OHSS incidence per randomized woman. Secondary outcomes were live birth rate, ongoing pregnancy rate, clinical pregnancy rate and miscarriage rate. Searches (until September 2009) were conducted in MEDLINE, EMBASE, Science Direct, Cochrane Library and databases of abstracts.
  
  
  RESULTS
  Four randomized trials entailing 570 women were included. There was evidence of a statistically significant reduction in the incidence of OHSS in the cabergoline group (OR 0.41, 95% CI 0.25-0.66) with an absolute risk reduction of 12% (95% CI 6.1-18.2%), but there was no statistically significant evidence of a reduction in severe OHSS (OR 0.50, 95% CI 0.20-1.26). There was no evidence for a difference in clinical pregnancy rate (OR 1.07, 95% CI 0.70-1.62) and miscarriage rate (OR 0.31, 95% CI 0.03-3.07).
  
  
  CONCLUSIONS
  Prophylactic treatment with the dopamine agonist, cabergoline, reduces the incidence, but not the severity of OHSS, without compromising pregnancy outcomes.
authors.affiliation: Department of Obstetrics and Gynaecology, Cairo University, Cairo, Egypt. m.a.youssef@amc.uva.nl
authors.forename: Mohamed A F M
authors.initials: MA
authors.lastname: Youssef
authors.forename: Madelon
authors.initials: M
authors.lastname: van Wely
authors.forename: Mohamed Ahmed
authors.initials: MA
authors.lastname: Hassan
authors.forename: Hesham Gaber
authors.initials: HG
authors.lastname: Al-Inany
authors.forename: Monique
authors.initials: M
authors.lastname: Mochtar
authors.forename: Sherif
authors.initials: S
authors.lastname: Khattab
authors.forename: Fulco
authors.initials: F
authors.lastname: van der Veen
mesh_terms: D000022:Abortion, Spontaneous; D000328:Adult; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D004873:Ergolines / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D015994:Incidence; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D016032:Randomized Controlled Trials as Topic
chemical_list: D018491:Dopamine Agonists; D004873:Ergolines; D000077465:Cabergoline