Coasting May Reduce the Severity of the Ovarian Hyperstimulation Syndrome in Patients with Polycystic Ovary Syndrome

Abstract

The aim of our study was to determine the efficacy of postponing administration of human chorionic gonadotropin while continuing daily gonadotropin-releasing hormone agonist therapy (‘coasting’) to prevent the occurrence of severe ovarian hyperstimulation syndrome (OHSS) for patients with polycystic ovary (PCO) syndrome. Five patients with PCO who had been hospitalized due to severe OHSS in previous in vitro fertilization and embryo transfer or intrauterine insemination cycles at the Tottori University Hospital were included in the study. The rates of mature oocytes and fertilization were comparable between the cycles. A singleton pregnancy was achieved in a patient during the coasting cycle, and none of the women developed severe OHSS in coasting cycles. The results suggest that coasting may be an alternative method for reducing the severity of OHSS in patients with PCO.

Coasting: What is the Cost?

“…Coasting was effective in preventing OHSS in five patients with polycystic ovary syndrome (PCOS) who had developed severe OHSS in a previous stimulation cycle [21]. Delvigne and Rozenberg, [22] assessed whether physicians modify their preventive attitude in relation to clinical factors and to the E2 response chart.…”

Unexpected pregnancy despite extremely decreased estradiol levels during ovarian stimulation

“…This strategy then was used in 40 patients with polycystic ovaries to avoid cycle cancellation for OHSS (5). Coasting has been successfully applied for more than 20 years as an effective preventative measure to avoid OHSS (6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”