Korean J Fertil Steril.  2007 Mar;34(1):49-56.

Short Coasting of One or Two Days by Withholding Both Gonadotropins and GnRH Agonist Prevents Ovarian Hyperstimulation Syndrome without Compromising the Outcome

• Lee SK
• Joo BS
• Park SH
• Lee SK
• Kim KS
• Moon SE
• Moon HS

Abstract

OBJECTIVE
To evaluate the effect of short coasting, by withdrawing both gonadotropins and GnRH agonist (GnRHa), on the prevention in severe ovarian hyperstimulation syndrome (OHSS) without compromising pregnancy outcome. METHOD: Thirty-seven women who had been coasted during COH for IVF were coasted when > or =20 follicles > 15 mm with serum E2 level of 4,000 pg/ml were detected. Coasting was initiated for one or two days depending on the status of follicle on ultrasound and serum E2 level. Both gonadotropin and GnRHa were withheld for coasting. Retrospective study was carried and changes of serum E2 levels, number of oocytes retrieved, fertilization rate, pregnancy rate were compared and analyzed.
RESULTS
The mean serum E2 level fell from 6,993 pg/ml on the onset of coasting to 3,396 pg/ml on the day of hCG administration. The mean number of oocytes retrieved and fertilization rate were 15.7 and 70.0%, respectively. Fifteen patients were pregnant (40.6%) and implantation rate was 15.2%. Twenty-six (70.3%) patients were coasted for one day and 11 (29.7%) were coasted for two days. The mean decrease rate of serum E2 level was 43% in one day coasting group and 15% (1st day) and 81% (2nd day) in two day coasting group. The pregnancy outcome was similar between the two groups. After coasting, no severe or moderate OHSS occurred in any patients and mild OHSS occurred in 3 (8.1%) patients.
CONCLUSIONS
Coasting for one or two days can be used successfully in the prevention of OHSS without compromising IVF cycle outcome.

Keyword

Coasting; Withdrawing GnRH agonist; Ovarian hyperstimulation syndrome; Pregnancy outcome

MeSH Terms

Female
Fertilization
Gonadotropin-Releasing Hormone*
Gonadotropins*
Humans
Oocytes
Ovarian Hyperstimulation Syndrome*
Pregnancy
Pregnancy Outcome
Pregnancy Rate
Retrospective Studies
Ultrasonography
Gonadotropin-Releasing Hormone
Gonadotropins