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.