What are the effects of dopamine agonists on ovarian hyperstimulation syndrome and pregnancy outcomes in women undergoing assisted reproductive technology therapy?

2017 ◽  
Author(s):  
Leonardo J Orozco
Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5354-5354
Author(s):  
Ophira Salomon ◽  
Gina Schiby ◽  
Zehava Heiman ◽  
Kamila Avivi ◽  
Joshua Dor ◽  
...  

Abstract In assisted reproductive technology (ART) high doses of human menopausal gonadotropins are used to induce controlled ovulation. This technology puts women at high risk of developing the ovarian hyperstimulation syndrome and thombotic events. Objective: To discern the reason for predilection of combined jugular and subclavian following ART. Methods: Women who developed combined jugular and subclavian vein thrombosis following assisted reproductive technology were included in the study. The thrombotic events were demonstrated by ultrasound Doppler or computerized tomography angiography. All women were interviewed and data obtained from outpatient clinic and hospital medical charts. Magnetic resonance imaging and complete thrombophilic profile work-up was performed in each woman. Open biopsy from the lesions was taken from one of the women for histological sections and immunohistochemical stains. Results: Five women developed combined jugular and subclavian vein thrombosis following ART. They were found to harbor clusters of rudimentary branchial cysts filled with fluid at the time of ovarian hyperstimulation syndrome, which compressed the jugular and subclavian veins at their junction at the base of the neck. Four patients (80%) were found to be carriers of factor V Leiden. Conclusion: The predilection of combined jugular and subclavian vein thrombosis early in pregnancy is the result of mechanical compression mediated by rudimentary branchial cysts filled with fluid during ovarian hyperstimulation syndrome, particularly in subjects who are carriers of factor V Leiden.


2019 ◽  
Vol 100 (2) ◽  
pp. 270-276
Author(s):  
E E Kraevaya ◽  
Ya A Petrosyan ◽  
N I Tapil'skaya

Idiopathic capillary leak syndrome was first described in 1960 and later received its name in honor of the discoverer - Clarkson's Disease. However, in the past two decades, more cases have been reported than in the previous 35 years, most likely due to improved recognition, the widespread use of assisted reproductive technologies in the treatment of infertility and the emergence of targer therapy - monoclonal antibodies for the treatment of cancer and autoimmune diseases. Except for Clarkson's disease, capillary leak syndrome can occur in engraftment syndrome, differentiation syndrome after bone marrow transplantation, ovarian hyperstimulation syndrome, hemophagocytic lymphohistiocytosis, viral infections, mostly hemorrhagic fevers, some autoimmune diseases, administration of recombinant interleukins, cytostatics, some monoclonal antibodies including treatment with the latest anticancer drugs - immune checkpoint inhibitors, snakebite envenomation, and ricin poisoning. This syndrome is characterized by a sharp increase in vascular permeability for fluid and protein molecules that leads to the loss of fluid into the interstitium, and presents with acute onset of severe edema, often asymmetric, hypotension, polyserositis, hemoconcentration and low blood protein level. In assisted reproductive technology programs, the introduction of gonadotropins results in an increase in estradiol levels, which leads to the development of immunopathological process, accompanied by leukocyte infiltration of blood vessels and secondary hypercytokinemia. Subsequently, the secondary «wave» of cytokines and vasoactive substances secreted in response to the introduction of human chorionic gonadotropin as an ovulation trigger, leads to disruption of interendothelial contacts and the development of ovarian hyperstimulation syndrome. It is necessary to conduct a further study of the pathogenesis of capillary leak syndrome, in order to develop promising methods for the prevention and correction of ovarian hyperstimulation syndrome in assisted reproductive technology programs.


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