Short coasting of 1 or 2 days by withholding both gonadotropins and gonadotropin-releasing hormone agonist prevents ovarian hyperstimulation syndrome without compromising the outcome.
OBJECTIVE
To evaluate the effect of short coasting, by withdrawing both gonadotropins and gonadotropin-releasing hormone (GnRH) agonist, on the prevention of severe ovarian hyperstimulation syndrome (OHSS) without compromising pregnancy outcome.


METHODS
Retrospective study.


METHODS
Large urban medical center.


METHODS
Forty-four women who had been coasted during controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF).


METHODS
When >or=20 follicles >15 mm with serum estradiol (E(2)) level of 4000 pg/mL were detected, both gonadotropins and GnRH agonist were withheld for 1 to 2 days.


METHODS
Changes of serum E(2) levels, number of oocytes retrieved, pregnancy rate.


RESULTS
The mean serum E(2) level fell from 7915 pg/mL at the onset of coasting to 3908 pg/mL on the day of human chorionic gonadotropin (hCG) administration. The mean number of oocytes retrieved and fertilization rate were 17.2% and 75.0%, respectively. Eighteen patients became pregnant (43.9%), and the implantation rate was 12.7%. Twenty-eight patients were coasted for 1 day, and 13 were coasted for 2 days. The mean decrease rate of serum E(2) level was 45.3% in 1-day coasting and 26.4% (first day) and 75.3% (second day) in 2-day coasting. The pregnancy outcome was similar between both groups. After coasting, three mild and two severe cases of OHSS occurred.


CONCLUSIONS
Coasting for 1 or 2 days can be used successfully to prevent OHSS without compromising IVF cycle outcome.
Moon
Hwa Sook
HS
Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Infertility, Good Moonhwa Hospital, Busan, South Korea. moonhwas@moonhwa.or.kr
Joo
Bo Sun
BS
Moon
Sung Eun
SE
Lee
Su Kyung
SK
Kim
Kyung Seo
KS
Koo
Ja Seong
JS
D000328:Adult; D004334:Drug Administration Schedule; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006062:Gonadotropins / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007246:Infertility / Q000378:metabolism / Q000628:therapy*; D054315:Oocyte Retrieval; D016471:Ovarian Hyperstimulation Syndrome / Q000209:etiology / Q000517:prevention & control*; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D006062:Gonadotropins; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol