Serum FSH Levels in Coasting Programmes on the hCG Day and Their Clinical Outcomes in IVF ± ICSI Cycles

Vitthala, S.; Bouaziz, Jérôme; Zosmer, Ariel; Al-Shawaf, Talha

doi:10.1155/2012/540681

Cited by 4 publications

(12 citation statements)

References 32 publications

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“…the current study's centre, based on 350 coasted cycles, did not find that serum FSH <5 IU/l discriminated between cycles resulting in clinical pregnancy or live birth compared with higher serum FSH, but no live birth was found in cycles when serum FSH fell below 2.5 IU/l on the HCG day at the end of coasting (Vitthala et al, 2012). The differences in results between the above studies could be explained by the different study populations and study designs.…”

Section: -Specificitycontrasting

confidence: 74%

“…A recent study estimated the best discriminative value of FSH at HCG injection in predicting CPR to be 4.9 IU/l (Erman Akar and Oktay, 2009). A recent paper from the current study centre indicated no live births occurring when the FSH fell below 2.5 IU/l on the day of HCG injection (Vitthala et al, 2012). This study aimed to determine if total fall or percentage fall in serum FSH from the start to end of coasting is correlated with clinical outcomes, primarily LBR and CPR.…”

Section: Introductionmentioning

confidence: 74%

“…This 22% difference in LBR just failed to achieve statistical significance; however, it might be of clinical significance. The magnitude of fall in serum FSH from start of coasting to the day of HCG as well as the absolute concentration of serum FSH on the day of HCG (>2.5 IU/l) may be a useful guide in deciding when to administer the HCG and proceed to oocyte retrieval without compromising the clinical outcome (Vitthala et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

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Can the fall in serum FSH during coasting in IVF/ICSI predict clinical outcomes?

Datta

Zosmer

Sabatini

et al. 2012

Reproductive BioMedicine Online

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This retrospective cohort study determined whether the total falls in serum FSH and oestradiol concentrations from start to end of coasting in IVF/intracytoplasmic sperm injection could predict clinical outcomes. Ninety-nine cycles, with gonadotrophin-releasing hormone-agonist down-regulation where coasting with serial serum oestradiol and FSH monitoring was adopted due to risk of severe ovarian hyperstimulation syndrome, were consecutively included. The primary clinical outcome was live-birth rate (LBR); other outcomes measured were number of oocytes retrieved and fertilization, implantation and clinical pregnancy rates. LBR for FSH fall>10 IU/l compared with 5-10 and<5 IU/l were 45.4% versus 22.0% and 25.0%, respectively. Mean serum FSH fall was similar with and without live birth (8.4 ± 6.2 versus 7.3 ± 5.0 IU/l) as were mean oestradiol and FSH concentrations on HCG administration, oestradiol fall, percentage fall in FSH/oestradiol and duration of coasting. None of the variables efficiently predicted live birth on regression analysis. The AUC of FSH fall was 0.53 at 11.0 IU/l. Basal FSH, starting and total gonadotrophin dose and duration of coasting were positively correlated with FSH fall. A potentially clinically important association between live birth and FSH fall during coasting was apparent, which requires further evaluation. The purpose of this retrospective cohort study was to determine whether the magnitude of fall in the serum FSH and oestradiol concentrations from start to end of coasting in IVF/intracytoplasmic sperm injection cycles could predict the clinical outcomes. Gonadotrophin-releasing hormone-agonist down-regulated cycles (n=99), where coasting with serial serum oestradiol and FSH monitoring was adopted due to risk of ovarian hyperstimulation, were consecutively included. Live birth was the primary clinical outcome measured; number of oocytes retrieved and fertilization, implantation and clinical pregnancy rates were the other outcomes examined. Live-birth rate tended to be high when FSH fall was >10 IU/l, compared with 5-10 IU/l and <5 IU/l, although not statistically significantly. Mean serum FSH fall were similar in live-birth and no-live-birth cycles (8.4 ± 6.2 versus 7.3 ± 5.0) as were mean oestradiol and FSH concentrations on hCG administration, oestradiol fall, percentage fall in FSH and oestradiol and duration of coasting. None of the variables efficiently predicted live birth. The area under the curve of FSH fall was 0.53. FSH fall of <11.0 IU/l was found to be more likely to predict negative outcome (specificity 84.72%) than predicting positive outcome when FSH fall was >11 IU/l (sensitivity 34.48%). Women's basal FSH, starting and total gonadotrophin dose of ovarian stimulation and duration of coasting had direct positive correlation with the magnitude of FSH fall. A potentially clinically important rise in live birth in association with greater FSH fall during coasting was apparent, which requires further evaluation.

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Section: -Specificitycontrasting

confidence: 74%

Section: Introductionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Can the fall in serum FSH during coasting in IVF/ICSI predict clinical outcomes?

Datta

Zosmer

Sabatini

et al. 2012

Reproductive BioMedicine Online

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“…Exogenous human chorionic gonadotrophin (hCG) has a major role in OHSS development via increasing capillary permeability (1). There are many treatment varients such as cycle cancel, witholding HCG, coasting, intravenous albumin and dopamin agonist administration to reduce incidince and severity of OHSS in high risk patient (2). Coasting, one of the most used methods, refers to witholding exogenous gonodotropine usage and delaying the administration of hCG in high risk cycles until serum estradiol falls into an acceptable range (typically less than 2500 to 3000 pg/mL) (2-7).…”

Section: Introductionmentioning

confidence: 99%

“…Coasting, one of the most used methods, refers to witholding exogenous gonodotropine usage and delaying the administration of hCG in high risk cycles until serum estradiol falls into an acceptable range (typically less than 2500 to 3000 pg/mL) (2-7). Coasting decreases FSH levels and causes granulosa cell apoptosis and inhibition of proliferation via luteinazition (2,6). As a conse-quence, coasting prevent onset of OHSS (2,8).…”

Section: Introductionmentioning

confidence: 99%

Effect of Coasting on Success of In-Vitro Fertilization Cycles

Şilfeler¹,

Gün²,

Kurt³

et al. 2016

Ulutas Med J

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Introduction: "Coasting" is a method used in prevention of Ovarian Hyperstimulation Syndrome (OHSS) during In Vitro Fertilization (IVF) cycles. Coasting refers to witholding exogenous gonodotropine usage and delaying the administration of hCG in high risk cycles until serum estradiol levels falls into an acceptable range. The aim of our study is to evaluate coasting effect on IVF oucomes in patients with E 2 levels of 4000-5000 pikogram.Method: This study was a single centered, retrospective and a case-control study. Study population were selected from women applied Zeynep Kamil Research Hospital IVF department between January 2003 and December 2013(n:7850). Patients were divided in 2 groups as conrol group (Group 1, n:48) and coasted group (Group 2, n:34) according to whether or not coasting performed.Results: E 2 levels on the day of hCG in group 2 were significiantly lower than group 1 (4332.6±256.6 and 3180.8±702.9; p<0.0001, respectively). There were no statistically significiant difference in follicle count before oocyte pick up, collected M2 oocyte count, fertilized oocyte count, pregnancy rate and OHSS incidence in between groups. Conclusion:Coasting is an effective method in high risk women to lower OHSS incidence. It can be appilied safely especially in patients having optimal follicular size and estradiol levels of 4000-5000

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Coasting, embryo development and outcomes of blastocyst transfer: a case–control study

Chahvar

Zosmer

Caragia

et al. 2014

Reproductive BioMedicine Online

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This study compared the effect on blastocyst development and clinical outcome of coasting in women at increased risk of moderate-severe ovarian hyperstimulation syndrome (OHSS; n=389) with a control group matched for age and basal FSH that did not undergo coasting (n=386) in IVF/intracytoplasmic sperm injection (ICSI) cycles. The main outcome measures were rate of blastocyst development and live birth. More cycles progressed to the blastocyst stage in the coasted group (n=169) compared with the control group (n=83; 43.4% versus 21.5%; P<0.001). The biochemical pregnancy, clinical pregnancy and live birth rates were similar (46.5% versus 42.0%; 40.6% versus 37.8%; 31.6% versus 30.1%). The duration of coasting up to 4 days did not affect progression to blastocyst stage. The multivariate model showed that coasting (OR 1.73, P=0.004) and the number of oocytes retrieved (OR 1.17, P=0.001) were positively correlated with blastocyst formation. Coasting, a measure to reduce the risk of OHSS, does not impair blastocyst development or clinical outcome. Coasting should remain an effective measure to prevent OHSS.

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Serum FSH Levels in Coasting Programmes on the hCG Day and Their Clinical Outcomes in IVF ± ICSI Cycles

Cited by 4 publications

References 32 publications

Can the fall in serum FSH during coasting in IVF/ICSI predict clinical outcomes?

Can the fall in serum FSH during coasting in IVF/ICSI predict clinical outcomes?

Effect of Coasting on Success of In-Vitro Fertilization Cycles

Coasting, embryo development and outcomes of blastocyst transfer: a case–control study

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