Hydroxychloroquine improves pregnancy outcomes of women with positive antinuclear antibody spectrum test results

Comparative study of cabergoline and hydroxychloroquine to prevent ovarian hyperstimulation syndrome (OHSS) in PCOS patients: a pilot randomized clinical trial

BACKGROUND

This study compared the effectiveness of cabergoline and hydroxychloroquine in preventing ovarian hyperstimulation syndrome (OHSS) in patients with polycystic ovary syndrome (PCOS) undergoing controlled ovarian stimulation.

MATERIALS AND METHODS

This double-blind, parallel, and randomized clinical trial was performed from April to June 2024. Forty-two patients with PCOS who were candidates for assisted reproductive techniques were randomized into two groups. The first group received 0.5 mg of cabergoline, and the second group received 400 mg of hydroxychloroquine for 8 days. Then, ultrasounds were conducted on days 3 and 5 after oocyte retrieval to assess for OHSS.

RESULTS

Three and five days after oocyte retrieval, laboratory findings, and clinical outcomes were similar between the cabergoline and hydroxychloroquine groups. Key laboratory parameters, including hemoglobin, hematocrit, sodium, potassium, blood urea nitrogen, and creatinine, did not show significant differences between the groups. On day three, OHSS incidence didn't have a significant difference between the hydroxychloroquine and cabergoline groups, both for the mild (31.58% vs. 42.86%) and moderate (15.79% vs. 9.52%) groups. Mild cases were observed in one of the patients in both groups 5 days after pickup (p = 0.942). No patients in the cabergoline group required hospitalization or treatment, compared to one in the hydroxychloroquine group (p = 0.127).

CONCLUSION

The incidence of OHSS was similar between cabergoline and hydroxychloroquine, with no significant differences observed in laboratory parameters or clinical outcomes after oocyte retrieval. However, given the study's sample size, further research is needed before these findings can be generalized to a larger population.

CLINICAL TRIAL NUMBER

http://www.irct.ir ; Registration number: IRCT20240305061171N1; Registration date: 2024 June 29.

Hydroxychloroquine as an Adjunct Therapy for Diabetes in Pregnancy

This review discusses the pathophysiology of diabetes in pregnancy in relation to the placental function. We review the potential use of hydroxychloroquine in improving pregnancy outcomes affected by diabetes. The review focuses on the mechanism of action of hydroxychloroquine and its potential effects on diabetes. There are several pathways in which hydroxychloroquine mediates its effects: through the inflammasome complex, inflammatory cytokines, oxidative stress, modulatory effects, and antihyperglycemic effects. As a safe drug to be used in pregnancy, it is worth exploring the possible use hydroxychloroquine as an adjunct treatment to the current therapy of diabetes in pregnancy.

Pregnancies through oocyte donation. A mini review of pathways involved in placental dysfunction

Pregnancies resulting from assisted reproductive techniques (ART) are increasingly prevalent worldwide. While most pregnancies conceived through in-vitro fertilization (IVF) progress without complications, mounting evidence suggests that these pregnancies are at a heightened risk of adverse perinatal outcomes. Specifically, IVF pregnancies involving oocyte donation have garnered attention due to numerous reports indicating an elevated risk profile for pregnancy-related complications within this subgroup of patients. The precise mechanisms contributing to this increased risk of complications remain incompletely understood. Nonetheless, it is likely that they are mediated by an abnormal immune response at the fetal-maternal interface. Additionally, these outcomes may be influenced by baseline patient characteristics, such as the etiology of infertility, absence of corpus luteum, and variations in endometrial preparation protocols, among other factors. This review aims to succinctly summarize the most widely accepted mechanisms that potentially contribute to the onset of placental dysfunction in pregnancies conceived through oocyte donation.