Does coasting, a procedure to avoid ovarian hyperstimulation syndrome, affect assisted reproduction cycle outcome?

OBJECTIVE

To evaluate the effects of coasting (withdrawing gonadotropin administration) on IVF outcome.

DESIGN

Retrospective study.

SETTING

Department of Infertility of Zekai Tahir Burak Women's Health Research and Education Hospital.

PATIENT(S): Ninety-four patients in whom coasting was applied (group 1). One control group consisted of 22 patients in whom coasting was not applied despite E(2) > 3000 pg/mL (group 2). A control group consisted of 111 normally responsive patients with peak E(2) < 3000 pg/mL level (group 3).

INTERVENTION(S): When E(2) levels were greater than 3000 pg/mL in the presence of at least 20 follicles, each measuring >or=10 mm in diameter with >or=20% of them of diameter >or=15 mm, recombinant FSH administration was discontinued while GnRH agonist was maintained.

MAIN OUTCOME MEASURE(S): Hormonal characteristics, IVF outcome, OHSS in coasted and noncoasted groups.

RESULT(S): There was no statistically significant difference between number of total oocytes retrieved, metaphase II oocytes, and fertilization rates among the group 1 vs. group 2. However, the implantation rates and pregnancy rates were significantly higher in group 1 compared with group 2. Group 1 had more total oocytes retrieved and metaphase II oocytes compared with group 3. However, there was no significant difference in implantation and pregnancy rates between groups 1 and 3.

CONCLUSION(S): Coasting does not adversely affect assisted reproductive technology outcome and can be applied safely to high responder patients in ICSI.