Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Objectives: to compare the efficacy of calcium gluconate infusion versus cabergoline in the prevention of ovarian hyperstimulation syndrome (OHSS) in patients pretreated with GnRH agonist long protocol that are at high risk for OHSS. Design: Randomized controlled study. Setting:Assisted conception unit of Al Gazeera hospital, Giza, Egypt. Patients: 170 patients who were stimulated using the long luteal GnRH agonist protocol and at high risk for developing OHSS (have more than 18 follicles (> 11mm) and serum estradiol {u2265} 3000 pg/ml on the day of HCG administration). Patients were randomized in a 1;1 ratio to the cabergoline group and the calcium gluconate group. Interventions:In cabergoline group, cabergoline at a daily dose of 0.5 mg was administered orally at bed time for 8 days starting on the day of HCG administration. In calcium gluconate group, intravenous calcium gluconate was administered (10%, 10 mL in 200 mL of physiologic saline, within 30 minutes) on the day of ovum pickup, day 1, day 2, and day 3 after ovum pickup. Measurements and Main Results:Six patients in cabergoline group and eight patients in calcium gluconate group developed moderate OHSS. One patient in each group developed severe OHSS. The incidence of moderate/severe OHSS was comparable between both groups (8.24% Vs 10.59%, P value = 0.599, OR= 0.76, 95% CI (0.269 - 2.138).The implantation, clinical pregnancy and ongoing pregnancy rates were similar in the two groups (16.91% vs. 15.84%, P = 0.771, 35.29% vs. 32.94%, P = 0.746, 30.59% vs. 28.24%, P = 0.736, respectively)

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