Publication:

Evaluation of a therapeutic combination to prevent ovarian hyperstimulation syndrome

Background Ovarian hyperstimulation syndrome (OHSS) remains a significant iatrogenic complication in assisted reproductive technology. Various strategies have been proposed to minimize its occurrence, particularly in high-risk patients. To evaluate the effectiveness of a combined preventive protocol including GnRH antagonist protocol, GnRH agonist trigger, dopamine agonist (cabergoline), calcium infusion, and a freeze-all strategy in reducing the incidence of OHSS without compromising IVF outcomes.

Methods A comparative study was conducted on women undergoing IVF, divided into a study group receiving the combined protocol and a control group managed conventionally. Primary outcomes included stimulation parameters, incidence of OHSS, and biochemical pregnancy rates. Secondary outcomes assessed included the number of cumulus-oocyte complexes (COCs), mature oocytes (MII), and vitrified embryos.

Results The study group showed significantly lower gonadotropin doses, with improved ovarian response reflected by higher numbers of COCs, MII oocytes, and vitrified embryos (p<0.05). Despite these improved biological outcomes, β-hCG positivity rates did not differ significantly between the two groups (24% vs. 26.5%; p=0.239). No cases of moderate or severe OHSS were observed in the study group.

Conclusions The combined use of multiple evidence-based strategies appears effective in reducing the risk of OHSS while maintaining satisfactory IVF outcomes. This multifaceted approach may offer a safer stimulation pathway for high-risk patients without compromising pregnancy potential.