title: Short coasting of 1 or 2 days by withholding both gonadotropins and gonadotropin-releasing hormone agonist prevents ovarian hyperstimulation syndrome without compromising the outcome.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Center for Reproductive Medicine and Infertility, Good Moonhwa Hospital, Busan, South Korea. moonhwas@moonhwa.or.kr
authors.forename: Hwa Sook
authors.initials: HS
authors.lastname: Moon
authors.forename: Bo Sun
authors.initials: BS
authors.lastname: Joo
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Moon
authors.forename: Su Kyung
authors.initials: SK
authors.lastname: Lee
authors.forename: Kyung Seo
authors.initials: KS
authors.lastname: Kim
authors.forename: Ja Seong
authors.initials: JS
authors.lastname: Koo
mesh_terms: 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
chemical_list: D005300:Fertility Agents, Female; D006062:Gonadotropins; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol