Agonist D2-dopamine receptors reduces hemoconcentration in hyperstimulated women undergoing assisted reproduction

Background. Ovarian hyperstimulation syndrome (OHSS) results from increased vascular permeability (VP) caused by ovarian hypersecretion of vascular endothelial growth factor (VEGF), which activates its receptor-2. In animals, the dopamine receptor 2 agonist cabergoline (Cb2) inactivates VEGF receptor-2 and prevents increased VP.Objective. Our objective was to test whether Cb2 reduces hemoconcentration and prevents OHSS in humans.Materials and methods. Cb2 0,5 mg/d (n=65) or a placebo (n=63) was administered from the day of oocyte retrieval (Day 0) until the day of embryo transfer (Day 5). Hemoconcentration were identified markers, such as hematocrit, hemoglobin, red blood cell count, platelet count and indicators of the inflammatory response of leukocytes.Results. Hematocrit (p<0,0001), hemoglobin (p<0,0001) were significantly lower on day 5 after treatment with Cb2 as compared with placebo. The incidence of OHSS was 7 (10,7%) and 19 (30,1%) respectively (p=0,0315). This reduces the risk (ARR) of complications absolute best 19% [CI 5-33%], and decrease the likelihood of ovarian hyperstimulation syndrome (OR) in 3,6 times [CI 1,3-9,3].Conclusion. Given that Cb2 is a well - established and safe medication, this study provides proof of concept for the use of dopamine agonists in the prevention of OHSS in women undergoing assisted reproduction. The preventive effect of selective dopamine D2-receptor agonist, cabergoline during the prevention of ovarian hyperstimulation syndrome manifests a decrease in the degree of hemoconcentration as one of the major pathophysiological stages of the syndrome.

ovarian hyperstimulation syndrome, D2-dopamine receptor agonist, cabergoline, drug prevention OHSS, reducing the likelihood of develop- ing OHSS