Calcium versus cabergoline for prevention of ovarian hyperstimulation syndrome: A systematic review and meta-analysis.

Autor: Baradwan S; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., AlJaroudi D; Department of Reproductive Endocrine and Infertility Medicine, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Saudi Arabia., Agdi M; Department of Reproductive Endocrinology and Infertility, Dr. Sulaiman Al Habib Medical Group, Sahafa Hospital, Riyadh, Saudi Arabia., Hafedh B; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Abduljabbar HH; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Sabban H; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia; Department of Obstetrics and Gynecology, Faculty of Medicine at Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia., Alzawawi N; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Alsaad N; Department of Reproductive Endocrine and Infertility Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia., Alshahrani MS; Department of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia., Idriss A; Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., AlSghan R; Department of Obstetrics and Gynecology, Maternity and Children Hospital, AlKharj, Saudi Arabia., Asiri M; Department of Obstetrics and Gynecology, Abha Maternity and Children Hospital, Abha, Saudi Arabia., Baradwan A; Department of Obstetrics and Gynecology, Al Salama Hospital, Jeddah, Saudi Arabia., Edrees A; Department of Research, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia., Abu-Zaid A; Department of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. Electronic address: aabuzaid@live.com.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2024 Oct; Vol. 301, pp. 1-11. Date of Electronic Publication: 2024 Jul 27.
DOI: 10.1016/j.ejogrb.2024.07.054
Abstrakt: Aim: To conduct the first-ever systematic review and meta-analysis evaluating calcium infusion versus cabergoline in preventing ovarian hyperstimulation syndrome (OHSS) among high-risk women undergoing assisted reproductive technology.
Methods: Six databases were screened from inception until April 1, 2024. The included randomized and non-randomized controlled studies were assessed for quality. The endpoints included the severity of OHSS and selected pregnancy-related outcomes. Endpoints were summarized as risk ratios (RRs) and 95% confidence intervals (CIs) in a random-effects model.
Results: Six studies were analyzed, including 1687 patients (828 in the calcium group and 859 in the cabergoline group). The quality of the studies varied and reflected low risk and high risk of bias in two and four studies, respectively, according to the revised Cochrane risk of bias tool. No significant differences were noted between both groups regarding the rates of overall (n = 5, RR = 0.65, 95 % CI [0.39, 1.07], p = 0.09), mild (n = 4, RR = 1.05, 95 % CI [0.59, 1.89], p = 0.86), moderate (n = 5, RR = 0.41, 95 % CI [0.15, 1.08], p = 0.07), and severe (n = 6, RR = 0.36, 95 % CI [0.11, 1.22], p = 0.1) cases of OHSS. Leave-one-out sensitivity analysis of an outlier study revealed that calcium significantly reduced the occurrence of severe OHSS compared with cabergoline (n = 5, RR = 0.16, 95 % CI [0.09, 0.43], p < 0.001, Higgins I 2  = 0 %). No significant differences were observed between both groups regarding the rates of clinical pregnancy (n = 4, RR = 0.97, 95 % CI [0.88, 1.07], p = 0.57), ongoing pregnancy, live birth, and spontaneous abortion (Higgins I 2  < 50 % for all).
Conclusion: Both agents yielded similar pregnancy-related outcomes. However, calcium infusion could potentially be more effective than cabergoline in reducing the rate of severe OHSS. Additional high-quality and well-controlled trials are essential to draw firm conclusions.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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