Authors: T. Al-Shawaf; A. Zosmer; A. Tozer; C. Gillott; A.M. Lower

Source: Human Reproduction, Volume 17, Number 5, May 2002 , pp. 1217-1221(5)

Publisher: Oxford University Press

Abstract:

BACKGROUND: Withholding gonadotrophins (coasting) can reduce the risk of severe ovarian hyperstimulation syndrome (OHSS) in patients having assisted reproduction therapy. This requires daily serum estradiol (E<INF>2</INF>) measurements, which occasionally have been seen to decline suddenly and sharply. METHODS: To increase the sensitivity of the coasting programme we measured serum FSH in parallel with E<INF>2</INF> in patients at risk of developing OHSS. RESULTS: Out of a total of 1240 cycles, 106 were coasted and in 89 both serum E<INF>2</INF> and FSH were measured at least twice during the coasting period. One case of late severe OHSS was encountered in the study group. The serum FSH declined by a rate of 24.3 ± 4.5% per day. Serum E<INF>2</INF> level reached a `safe level' of <10 000 pmol/l when the serum FSH declined to 5 IU/l or less. CONCLUSION: The results from this study show that measuring serum E<INF>2</INF> and FSH can assist in predicting the point at which serum E<INF>2</INF> has declined to a level safe enough to administer the trigger HCG.

Keywords: assisted reproduction; coasting; OHSS; serum estradiol; serum FSH

Document Type: Research article

Affiliations: 1: St Bartholomew's and The London NHS Trust, Reproductive Medicine Centre, 2nd Floor KGV Block, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE and

Publication date: 2002-05-01

More about this publication?

• Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.

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