Ovarian Hyperstimulation Syndrome Clinical Trial
Official title:
The Influence of Timing of Cabergoline Initiation on Prevention of Ovarian Hyper Stimulation Syndrome in Patients Undergoing Intra Cytoplasmic Sperm Injection .
Study the effect of early cabergoline administration in prevention of occurrence or decreasing the severity of OHSS in patients undergoing intra cytoplasmic sperm injection.And its effect on oocyte maturation,fertilization and pregnancy rate..
Patients less than 35years undergoing Intra Cytoplasmic Sperm Injection for infertility
scheduled for gonadotropin releasing hormone agonist long protocol of ovarian stimulation.
All patient will receive combined oral contraceptive pills (Gynera, Schering-plow: plough)
starting from day 5 of cycle that precedes the stimulated cycle .On day 21 of that cycle all
patients will start to receive Gonadotrophin releasing hormone agonist in the form of
(decapeptyl 0.1 sc daily and continued till the day of HCG administration).
To ensure that all patients are completely down regulated and desensitized ,trans-vaginal
ultrasound will be performed at day 2-3 of menses of stimulated cycle to ensure endometrial
thickness less than 5 mm and no ovarian cysts.Also serum E2 level is less than 50 pg/ml.
Then all patients will start to receive Gonadotrophin ( HMG) (Menogon, ferring
pharmaceuticals, Germany) 225 IU (international unit) Intramuscular Injection daily,with
continuous scheduled follow up of ovarian response by serial trans -vaginal US to assess
follicular growth together will serial serum E2 starting from day 6 of cycle and onwards.With
adjustments of gonadotropin dose and monitoring frequency based on patient response.
During follow up once the recruited patients fulfilling the inclusion criteria (serum E2
equal or more than 4000 pg/ml and /or 18 or more follicles of 11 mm diameter or more at any
day of stimulation),they will be allocated randomly by computer generated cards and assigned
by sealed envelopes by the treating doctor at the outpatient clinic.
Group A : will receive cabergoline 0.5 mg/day for 8 days, starting in the day of HCG (human
chorionic gonadotropin ) injection.
Group B: will receive cabergoline 0.5 mg/day once the criteria of inclusion criteria is
fulfilled and continued till the day of human chorionic gonadotropin (HCG ) trigger and
continued 8 days more from day of trigger .
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