Coasting (withholding gonadotrophins) for preventing ovarian hyperstimulation syndrome

Abstract

4 95%CI includes no effect and appreciable benefit or harm 5 95%CI includes both no effect and appreciable benefit and apreciable harm xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx 5 Coasting (withholding gonadotrophins) for preventing ovarian hyperstimulation syndrome (Review)

The effect of duration of coasting and estradiol drop on the outcome of assisted reproduction: 13 years of experience in 1,068 coasted cycles to prevent ovarian hyperstimulation

“…Reported E 2 cut-offs for initiation of coasting have varied from 2,500 pg/mL (9,175 pmol/L) (20) to 6,000 pg/mL (22,020 pmol/L) (21). Although randomized trials are lacking (22), large retrospective series suggest a lower incidence of OHSS in coasted cycles than would be expected from the literature (23,24).…”

Ovarian hyperstimulation syndrome: pathophysiology and prevention

“…Although coasting is one of the most common strategies for preventing OHSS and is considered to be of great benefit because a significant decrease in estradiol levels is clear, there are a lack of randomized controlled trials (RCT) in which coasting is compared to not coasting. The evidence is still insufficient to determine whether coasting is an effective strategy for preventing OHSS [28], and the incidence OHSS can be as high as 9.4% even with coasting [29].…”

Coasting vs. cryopreservation of all embryos for prevention of ovarian hyperstimulation syndrome in in vitro fertilization

“…Only one study of which we are aware calculated a cumulative pregnancy rate for patients undergoing either of these strategies. Tummon et al (11) found a cumulative pregnancy rate of 77% in a series of 30 patients who were undergoing cryopreservation of all embryos. To our knowledge, this parameter has not been previously assessed in coasting cycles.…”

“…A qualitative systemic review concluded that coasting results in acceptable pregnancy rates but does not completely avoid the risk of OHSS (10). A Cochrane review found insufficient prospective evidence to indicate whether coasting affects either the incidence of OHSS or pregnancy rates (11). Similarly, cryopreservation of all embryos has been the subject of several retrospective series, which have indicated a reduction in OHSS risk and acceptable pregnancy rates (12)(13)(14).…”