Effect of coasting on cycle outcome during in vitro fertilization/intracytoplasmic sperm injection cycles in hyper-responders.
OBJECTIVE
To investigate the effect of coasting on IVF outcome in GnRH agonist cycles.


METHODS
Retrospective analysis.


METHODS
Private IVF center.


METHODS
Infertile couples undergoing IVF/intracytoplasmic sperm injection (ICSI) treatment (normal responders [control], hyper-responders [coasting] groups).


METHODS
Coasting to reduce the risk of ovarian hyperstimulation syndrome (OHSS) among hyper-responders.


METHODS
Stimulation, embryology parameters, and pregnancy rate (PR).


RESULTS
The average length of coasting was 2.2 days. Age and baseline FSH were comparable to control cycles. There were more follicles and oocytes in the coasting group, but the number of fertilized oocytes and embryos transferred were similar. Implantation rate (22.4% vs. 13.9%) was higher in the control group but the PRs were comparable (45.1% vs. 38.5%). Within the coasting group, baseline, stimulation, and embryology parameters were comparable between successful and unsuccessful cycles. Pregnancy rates were comparable after 1, 2, and 3 or more days of coasting (36.3% vs. 38.4% vs. 40%). Pregnancy rates were also comparable (28.5% vs. 35.7% vs. 44.4%) when groups were compared based on change in E2 (<25%, 25%-50%, >50%).


CONCLUSIONS
Coasting for 3 days can be used successfully in the management of the hyper-responding patients during IVF.
Kaáli Institute IVF Center, Budapest, Hungary. peterkovacs1970@hotmail.com
Péter
P
Kovács
Szabolcs
S
Mátyás
Steven G
SG
Kaali
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D008297:Male; D008597:Menstrual Cycle / Q000502:physiology; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology / Q000517:prevention & control*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013997:Time Factors