Comparison of Cabergoline and Quinagolide in Prevention of Severe Ovarian Hyperstimulation Syndrome among Patients Undergoing Intracytoplasmic Sperm Injection

Background: The aim of the current study is to compare quinagolide with cabergoline in prevention of ovarian hyper-stimulation syndrome (OHSS) among high risk women undergoing intracytoplasmic sperm injection (ICSI). Materials and Methods: This randomized clinical trial study was performed from March 2015 to February 2017. One hundred and twenty six women undergoing ICSI who were at high risk of developing OHSS (having over 20 follicles of > 12 mm), were randomized into two groups. The first group received cabergoline 0.5 mg and the second group received quinagolide 75 mg every day for 7 days commencing on the day of gonadotropin-releasing hormone (GnRH) agonist administration. Then OHSS symptoms as well as their severity were assessed according to standard definition, 3 and 6 days after GnRH agonist administration. Ascites were determined by trans-vaginal ultrasound. Other secondary points were the number of oocytes and the number of embryos and their quality. Quantitative and qualitative data were analyzed using Student's t test, and Chi-square or fisher's exact test, respectively. A P<0.05 was considered statistically significant. Results: The incidence of severe OHSS in the quinagolide-treated group was 3.1% while it was 15.8% in cabergoline-treated subjects (P<0.001). Ascites were less frequent after treatment with Quinagolide as compared to cabergoline (21.9 vs. 61.9%, respectively) (P=0.0001). There was no significant statistical deferences between the two groups in terms of mean age, number of oocytes, metaphase I and metaphase II oocytes, and germinal vesicles. There was a significant difference between cabergoline and quinagolide groups regarding the embryo number (P=0.037) with cabergoline-treated group showing a higher number of embryos. But, the number of good quality embryo in quinagolide-treated individuals was significantly higher than that of the cabergoline-treated group (P=0.001). Conclusion: Quinagolide seems to be more effective than Cabergoline in prevention of OHSS in high-risk patients undergoing ICSI.