From the Research
Cabergoline should be started on the day of egg retrieval or within 1-3 days after the procedure for patients at high risk of ovarian hyperstimulation syndrome (OHSS). The standard regimen is 0.5 mg once daily for 7-8 days. For patients with very high risk factors, such as more than 20 follicles or estradiol levels above 3000 pg/mL, treatment may begin preventatively on the day of trigger shot 1. Cabergoline works by inhibiting vascular endothelial growth factor (VEGF), which reduces vascular permeability and fluid leakage into the abdominal cavity—the primary mechanism behind OHSS symptoms. This medication is particularly effective for preventing early-onset OHSS but may be less effective for late-onset cases.
Some key points to consider when administering cabergoline for OHSS prevention include:
- The dose and duration of cabergoline treatment may vary depending on the individual patient's risk factors and response to treatment 2, 3
- Cabergoline has been shown to reduce the incidence of early-onset OHSS, but its effectiveness in preventing late-onset OHSS is less clear 4
- Patients should be closely monitored for signs and symptoms of OHSS, including severe abdominal pain, significant weight gain, severe nausea/vomiting, decreased urination, or shortness of breath, and should report these symptoms immediately if they occur
- Common side effects of cabergoline include nausea, headache, and dizziness, which are usually mild 5, 1
Overall, the use of cabergoline for OHSS prevention is supported by the evidence, and it should be considered as part of a comprehensive treatment plan for patients at high risk of OHSS.