Authors: Delvigne A.; Rozenberg S.

Source: Human Reproduction Update, Volume 8, Number 3, May 2002 , pp. 291-296(6)

Publisher: Oxford University Press

Abstract:

‘Coasting’, a method which consists of stopping exogenous gonadotrophins and postponing HCG administration until the patient’s serum estradiol (E<inf>2</inf>) level decreases, is often used to prevent ovarian hyperstimulation syndrome (OHSS). We conducted a systematic review to analyse whether there is sufficient evidence to justify the general acceptance of coasting. The studies, which involved 493 patients in 12 studies, are very heterogeneous in the characteristics and number of patients in the ovulation stimulation schemes. The study designs, control groups, selection criteria for coasting and the OHSS classifications were variable. In most studies a threshold value of E<inf>2</inf> was used (often 3000 pg/ml) and/or the number of follicles were considered. The fertilization rates (36.7–71%) and the pregnancy rates (20–57%) were acceptable in terms of IVF results in comparison with those of other large IVF databanks. In 16% of the cycles, ascites was described and 2.5% of the patients required hospitalization. In conclusion, while coasting does not avoid totally the risk of OHSS, it decreases its incidence in high-risk patients. Many questions remain unanswered about how coasting should be managed, and we suggest that a randomized prospective multicentre study is required.

Keywords: coasting; IVF; OHSS; prevention

Document Type: Research article

Affiliations: 1: IVF Centre, Department of Obstetrics–Gynaecology, Free University of Brussels (ULB), University Hospital St Pierre, rue Haute 322, B-1000 Brussels, Belgium

Publication date: 2002-05-01

More about this publication?

• Human Reproduction Update, first published in 1995, aims to provide invited, comprehensive, authoritative, up-to-date critical and balanced reviews covering all areas of human reproduction including 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 and counselling, ethics and social issues. These papers are peer-reviewed to the highest editorial and scientific standards. Human Reproduction Update is published on behalf of the European Society of Human Reproduction and Embryology (ESHRE).

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