Predictors of success during the coasting period in high-responder patients undergoing controlled ovarian stimulation for assisted conception.
OBJECTIVE
To determine the prognostic factors analyzed during the coasting period that can be used to predict outcomes of IVF cycles.


METHODS
Retrospective review of data from a single center.


METHODS
Referral private IVF center.


METHODS
Three hundred forty-six patients who were coasted for the prevention of ovarian hyperstimulation syndrome (OHSS) and 262 patients who were not coasted but having excessive E(2) levels during controlled ovarian hyperstimulation for assisted conception.


METHODS
Controlled ovarian hyperstimulation, oocyte retrieval, intracytoplasmic sperm injection, and embryo transfer.


METHODS
Number of total oocytes retrieved, oocyte maturity, fertilization, implantation and pregnancy rates (IR and PR, respectively), and incidence of severe OHSS.


RESULTS
No difference was found between early onset coasted patients, late onset coasted patients, and uncoasted patients in terms of fertilization rates, IR, PR, and incidence of severe OHSS. Fertilization and PR did not correlate significantly with decreases in E(2) level during the coasting period. Implantation rates and PR in patients who were coasted > or =4 days were significantly reduced compared with patients who were coasted for 1-3 days. In logistic regression model, the decrease in PR with prolonged coasting was found to be significant; however, there was no correlation between decreased PR and the decrease in E(2) levels during the coasting period.


CONCLUSIONS
Coasting can be applied safely to controlled hyperstimulation cycles without compromising the outcome. The duration of coasting seems to be a prognostic factor for the outcome of IVF. The criteria for initiation of coasting should be based on clinical experience and assessment of the patient.
Bahceci Women Health Care Center and German Hospital at Istanbul, Nisantasi, 80200 Istanbul, Turkey.
Ulun
U
Ulug
Izhar
I
Ben-Shlomo
Mustafa
M
Bahceci
D016208:Databases, Factual; D010064:Embryo Implantation; D005260:Female; D005306:Fertilization; D006801:Humans; D007246:Infertility / Q000209:etiology; D008297:Male; D010062:Ovulation Induction / Q000379:methods*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014421:Turkey