"Coasting" does not adversely affect cycle outcome in a subset of highly responsive in vitro fertilization patients.
OBJECTIVE
To study the effect of postponing hCG administration while continuing daily GnRH agonist therapy ("coasting") on highly responsive patients undergoing IVF-ET.


METHODS
Retrospective analysis.


METHODS
University-affiliated Center for Fertility and Reproductive Medicine.


METHODS
Patients undergoing IVF-ET from March 1995 to March 1997.


METHODS
Three groups of IVF-ET patients were compared to explore the effect of coasting on cycle outcome: a group of highly responsive coasted patients, a group of equally responsive noncoasted patients, and an age-matched normally responsive control group. Two groups of coasted patients were also compared to assess the effect of E2 levels at the time that they met the follicular criteria for hCG administration. Last, the effect of varying coast duration was examined by regression analysis.


METHODS
Patient characteristics, outcome parameters, and incidence of ovarian hyperstimulation syndrome (OHSS).


RESULTS
Coasting had no detrimental effect on cycle outcome in the subset studied. Regression analysis, however, suggests an inverse relationship between coast duration and the number of mature oocytes retrieved as well as the clinical pregnancy rate.


CONCLUSIONS
Coasting in the studied subset of IVF patients did not adversely affect cycle outcome parameters or the incidence of OHSS, but prolonged coasting intervals may impair IVF cycle outcome.
Tortoriello
D V
DV
Center for Fertility and Reproductive Medicine, Unviersity of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103, USA.
McGovern
P G
PG
Colón
J M
JM
Skurnick
J H
JH
Lipetz
K
K
Santoro
N
N
D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D004624:Embryo Transfer / Q000379:methods*; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007246:Infertility / Q000628:therapy; D016729:Leuprolide / Q000008:administration & dosage*; D016015:Logistic Models; D008297:Male; D008845:Microinjections; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control*; D011247:Pregnancy; D011374:Progesterone / Q000097:blood; D012189:Retrospective Studies
D006063:Chorionic Gonadotropin; D011374:Progesterone; D004958:Estradiol; D016729:Leuprolide