Dopamine agonist can prevent ovarian hyperstimulation syndrome in IVF patients

A class of drug widely used in a number of gynaecological conditions can prevent ovarian hyperstimulation syndrome (OHSS), an infrequent but serious complication of assisted reproduction treatments, a scientist told the 22nd annual conference of the European Society of Human Reproduction and Embryology in Prague, Czech Republic, on Wednesday 21 June 2006. Dr. Claudio Alvarez, from the Instituto Valenciano de Infertilidad, Valencia, Spain, said that his team's work, using the dopamine agonist cabergoline, was the first successful attempt to prevent this disorder.

OHSS can occur when drugs are used to stimulate the ovaries to produce the eggs needed for fertilization in IVF treatment. The ovaries become larger than normal, and there can be a build-up of fluid in the abdomen. In severe cases there may also be hemoconcentration (decrease of the fluid content of the blood, with a resulting increase in its concentration), and kidney and liver damage; this can be life-threatening. Although OHSS has been known for many years, until now it has been treated empirically and the underlying causes have been little understood.

Animal models had shown that increased vascular permeability (VP), a factor in OHSS, was associated with an increased expression in the ovary of vascular endothelial growth factor (VEGF), responsible for the growth of blood vessels. The binding of VEGF to its receptor VEGFR2 increases VP. "We knew that dopamine and its agonists also reverse increased VP in hyperstimulated animals", said Dr. Alvarez, "so we decided to see whether it could prevent OHSS in women undergoing ovarian stimulation for ART."

Dopamine agonists are widely used in gynaecological conditions, especially in patients with hyperprolactinemia - a condition where the presence of abnormally high levels of the hormone, prolactine, can cause a number of disorders affecting fertility and their safety record is good. So Dr. Alvarez and his team began a stu

Contact: Mary Rice
European Society for Human Reproduction and Embryology

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