Combined use of Letrozole, Cabergoline and GnRH antagonist Eliminates Ovarian Hyperstimulation Syndrome (OHSS) in Polycystic Ovarian Syndrome (PCOS)

Aim: To determine if the properly timed, combined used of Letrozole, Cabergoline and GnRH antagonist eliminate the occurrence of ovarian hyper stimulation syndrome (OHSS) in polycystic ovarian syndrome (PCOS)? Study Design: We compared the severity of OHSS after using a new treatment with the severity of OHSS in a group of PCOS patients who received the GnRH antagonist-GnRH agonist- based controlled ovarian stimulation (COS) in retrospective cohort study between August 2019 and December 2021. Materials and Methods: 53 PCOS patients received the new treatment were compared to 32 PCOS patients treated with conventional methods. 5mg of Letrozole, 0.5mg of Cabergoline and 0.25mg of GnRH antagonist were administered from just after the oocyte pick up (OPU) for five consecutive days. Results: There were no significant differences in the clinical pregnancy rate, cumulative pregnancy rate and cumulative live birth rate between the two COS. The number of days between OPU and menstruation start in the novel COS was significantly lower than that of the conventional one (5.26+2.59 vs. 17.62+5.75). This treatment produced no incidences of OHSS, compared to 21.9% of all cases having mild OHSS with the conventional method. Conclusion: We found that administering Letrozole, Cabergoline and GnRH antagonist for five days consecutively after OPU effective for the complete prevention of OHSS.