JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):87
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263667

P-75. Efficacy of a modified high dose GnRHant with Cabergoline and adjuvant medications treatment, in Ovarian Hyperstimulation Syndrome(OHSS)

Lister Lima Salgueiro¹, Bernardo Lamounier Moura¹, Suelen Patricia Lima¹, Adrielly Stefani¹, Samira Orlando¹, Edson Lo Turco¹, Juliana Rainha Rolim¹

¹ Clinica de Medicina Reprodutiva Fertilis – Sorocaba – SP - Brasil

Objective: To analyze the effectiveness of a high-dose GnRH antagonist (4 syringes applied at once) combined with Cabergoline and symptomatic (adjuvant) medications in treating In Vitro Fertilization Ovarian Hyperstimulation Syndrome (OHSS)
Methods: This retrospective observational study evaluated data. Fifty-five patients diagnosed with OHSS were treated with high doses of Cetrorelix (4 syringes applied at once), Cabergoline, and symptomatic medications (Albumin, Metamucil, Kyss Kryss, Tramadol, Aspirin, Simethicone, and Oral Hydration) on the day of oocyte pickup. Due to the potential lethality of OHSS, no control group was included, and results were compared with published data.
Results: Among the 55 patients treated under this protocol, 70.0% were classified as having mild OHSS, and 30.0% moderate. No severe cases were observed within the mild OHSSgroup, 24.0% evoluted with no clinical symptoms, 55.0% experienced symptoms for 4 days, 14.0% for 7 days, and 7.0% for 10 days. Sixteen patients (29%) underwent Culdocentesis due to Ascites, with no hospitalizations required. Regarding age distribution, 55% of patients were under 35 years, 36% were between 35 and 39 years, and 9% were over 40 years. Primary diagnoses included Polycystic Ovary Syndrome (PCO) in 60.0% of cases, Endometriosis in 20%, and low testosterone levels in 23.6%.
Conclusion: The protocol utilizing Cabergoline and diary GnRH antagonist, either alone or in combination, with Cabergoline reduces, but does not completely eliminate the occurrence of severe OHSS. The modified treatment with high dose Cetrorelix plus Cabergoline and adjuvant medications, after egg collection demonstrated efficacy in controlling OHSS. The rapid action (within 24 hours) of the GnRH antagonist combined with Cabergoline, particularly in higher doses, appears to have a significant hormonal blocking effect. This outpatient-based treatment protocol effectively reduced severity symptoms, avoiding hospitalization, or severe cases. This technique presents a potentially safe alternative to OHSS conventional treatments.