Comparison of coasting and intravenous albumin in the prevention of ovarian hyperstimulation syndrome.
OBJECTIVE
To compare the efficacy of coasting to prevent ovarian hyperstimulation syndrome (OHSS) with i.v. albumin and to determine if different timing of gonadotropin coasting would affect the IVF outcomes.


METHODS
Retrospective study.


METHODS
University hospital-based IVF program.


METHODS
One hundred sixty-two women undergoing IVF treatment cycles who were considered to be at high risk for developing OHSS.


METHODS
Gonadotropin administration was withheld in 60 patients: either coasting occurred before follicular maturation (early coasting subset, n = 28) or follicular maturity was attained before coasting (late coasting subset, n = 32). Outcomes were compared in 102 patients at risk for OHSS who received i.v. albumin on the day of oocyte retrieval.


METHODS
Incidence of OHSS and outcome parameters.


RESULTS
Although the fertilization rates and the incidence of OHSS did not differ significantly between the coasting and i.v. albumin groups, the mean number of oocytes retrieved, the pregnancy rates, and implantation rates were significantly lower in the coasting group. There is no statistical difference in the entire outcome examined and the incidence of OHSS between the early and late coasting subsets.


CONCLUSIONS
Coasting is as effective as i.v. albumin in preventing OHSS in high-risk patients but yields inferior pregnancy rates. Early coasting is as successful as late coasting in preventing OHSS with similar IVF outcome.
Chen
Chin-Der
CD
Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Chao
Kuang-Han
KH
Yang
Jehn-Hsiahn
JH
Chen
Shee-Uan
SU
Ho
Hong-Nerng
HN
Yang
Yu-Shih
YS
D000328:Adult; D000418:Albumins / Q000008:administration & dosage*; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000494:pharmacology*; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control*; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013997:Time Factors
D000418:Albumins; D006063:Chorionic Gonadotropin; D004958:Estradiol