Publication:

Is cabergoline mystical in euprolactemic polycystic ovarian syndrome

Background Polycystic ovarian syndrome (PCOS) is most common in reproductive age females. Cabergoline is a potent long-acting dopamine agonist play an important role in decreasing high prolactin secretion which is present in 30–40% of PCOS and induce ovulation in those with normal prolactin level also. This is attributed to reduction of an occult hyperprolactinemia in PCOS patients.

Methods This is a randomized, prospective, controlled study includes 100 Euprolactinemic infertile PCOS, 50 in each group, Group A (letrozole cabergoline group) patients received tablet letrozole 5 mg/day in 2 divided doses 2.5 mg from cycle day 3 to day 7 plus cabergoline tablet 0.25 mg, half tablet twice weekly for 4 weeks starting from cycle day 3 with letrozole despite normal serum prolactin level. Group B (letrozole Group):patients received only letrozole same as group A. Primary outcomes-ovulation rate, number of dominant follicles and secondary outcomes-pregnancy, miscarriage, multiple pregnancies, OHSS, side-effects of cabergoline were studied. Statistical analysis was done.

Results Study groups compared for the demographic characters, basic clinical data, duration and type of infertility which showed no significant difference. Statistically significant difference in group A ovulation rate 76% (p value 0.0124), number of dominant follicles (p value 0.029). Pregnancy rate 72% in group A and 48% in group B (p value 0.014). No statistical difference in miscarriage (p value 0.15), twin pregnancies (p value 0.86), OHSS (p value 1.0) and no side effects.

Conclusions Addition of cabergoline to Letrozole in induction of ovulation in euprolactinemic infertile PCOS results in increased ovulation, high pregnancy rate compared to use of letrozole alone, with very few side-effects.