From the Research
Cabergoline is not contraindicated in ovarian hyperstimulation syndrome (OHSS) and can be used as a treatment for established severe OHSS, as well as a preventive measure in high-risk patients undergoing fertility treatments. The most recent and highest quality study, published in 2022 1, compared the efficacy of calcium infusion versus cabergoline in the prevention of OHSS in IVF patients at high risk for OHSS, and found that both treatments have comparable effectiveness in preventing OHSS.
Key Points
- Cabergoline can be used to treat established severe OHSS, as shown in a study published in 2014 2, where high-dose oral cabergoline was effective in managing six patients with established severe OHSS.
- The typical prophylactic dosage of cabergoline is 0.5 mg daily for 8 days, starting on the day of human chorionic gonadotropin (hCG) administration or on the day of oocyte retrieval.
- Cabergoline works by inhibiting vascular endothelial growth factor (VEGF) receptor-2 phosphorylation, which reduces vascular permeability—a key pathophysiological mechanism in OHSS.
- The medication is generally well-tolerated, with potential side effects including nausea, headache, and dizziness, as reported in a study published in 2012 3.
- Patients with severe hepatic impairment or uncontrolled hypertension should use cabergoline with caution.
Treatment Considerations
- Cabergoline may not be sufficient alone for high-risk patients, who might require additional preventive strategies, such as calcium infusion, as shown in the 2022 study 1.
- The incidence of moderate/severe OHSS was comparable between cabergoline and calcium gluconate groups in the 2022 study, with no significant difference in pregnancy, implantation, or miscarriage rates.
- Cabergoline has been shown to reduce the risk of OHSS in high-risk women, especially for moderate OHSS, as reported in a study published in 2012 3.