Comparison of 3-Day and 7-Day Gonadotropin-Releasing Hormone Antagonist Treatment for the Prevention of Ovarian Hyperstimulation Syndrome in Women Undergoing Assisted Reproductive Technologies: A Prospective Randomized Control Pilot Trial Publisher



V Hazari VAJIHE ; A Najafian AYDA ; H Salehiniya HAMID
Source: Clinical and Experimental Obstetrics and Gynecology Published:2025

Abstract

Background: Assisted reproductive technology (ART) protocols can lead to a serious and potentially life-threatening complication known as ovarian hyperstimulation syndrome (OHSS). The present study investigated and compared the effects of gonadotropin-releasing hormone (GnRH) antagonist (GnRH-ant) administration over 3-day and 7-day periods in women at high risk for OHSS. Methods: In this prospective randomized controlled pilot trial, an antagonist protocol was employed as part of ART in 41 patients aged 18 to 40 who were referred to the Infertility Center. After egg retrieval, subjects in group 1 received cabergoline in combination with 7 days of cetrorelix (one subcutaneous ampoule of cetrorelix once daily), while participants in group 2 received cabergoline along with 3 days of cetrorelix (one subcutaneous ampoule daily). Upon enrollment, participants were administered cabergoline tablets (Cabergolex 0.5 mg) at a dose of 0.5 mg orally at bedtime for 8 consecutive days. Ultrasound and clinical examinations were performed on the day of oocyte retrieval and on days 4, 8, and 14 thereafter to detect the occurrence of OHSS. Data were analyzed using SPSS version 22, with independent samples t-test and Chi-square test conducted at a significance level of <0.05. Results: The patients in the 3-day treatment group were aged between 30.30 ± 6.46 years, while those in the 7-day treatment group were between 29.09 ± 5.59 years, with no statistically significant difference between themean groups (p = 0.528). No hospitalizations were necessary in either the 3-day and 7-day treatment groups, and no cases of severe OHSS were observed. Moderate OHSS occurred in 6 patients (20%) in the 3-day treatment group and 5 patients (23.8%) in the 7-day treatment group, with no statistically significant difference between the groups (p = 0.768). Conclusions: A 3-day treatment appears to be as effective as a 7-day treatment in preventing OHSS. Clinical Trial Registration: This study is registered on the Iranian Registry of Clinical Trials (IRCT) at https://trialsearch.who.int/Trial2.aspx?TrialID=IRCT20201126049497N1 (registration number: IRCT20201126049497N1). © 2025 Elsevier B.V., All rights reserved.