Correctly timed coasting reduces the risk of ovarian hyperstimulation syndrome and gives good cycle outcome in an in vitro fertilization program
| Autor: | J Domitrz, Szamatowicz M, Waldemar Kuczyński, D Grochowski, S. WołzyńSki, Jacek Szamatowicz |
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| Rok vydání: | 2001 |
| Předmět: |
endocrine system
medicine.medical_specialty Time Factors medicine.drug_class Endocrinology Diabetes and Metabolism medicine.medical_treatment Ovarian hyperstimulation syndrome Fertilization in Vitro Biology Chorionic Gonadotropin Intracytoplasmic sperm injection Human chorionic gonadotropin Andrology Ovarian Hyperstimulation Syndrome Endocrinology Human fertilization Ovarian Follicle Pregnancy medicine Humans Embryo Implantation Sperm Injections Intracytoplasmic Gynecology Cryopreservation In vitro fertilisation Estradiol Obstetrics and Gynecology medicine.disease Embryo Transfer Embryo transfer Pregnancy rate Infertility Female Gonadotropin hormones hormone substitutes and hormone antagonists |
| Zdroj: | Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 15(3) |
| ISSN: | 0951-3590 |
| Popis: | One hundred and twelve severely overstimulated in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) patients were treated with coasting when estradiol concentration was3000 pg/ml and the leading follicles had attainedor = 18 mm in diameter. Gonadotropin withholding was offered to them as a promising method for the prevention of both cycle cancellation and complications associated with severe ovarian hyperstimulation syndrome (OHSS). The duration of prolonged coasting prior to human chorionic gonadotropin (hCG) administration ranged from 2 to 9 days (mean 3.5). hCG was administered when the serum estradiol dropped to3000 pg/ml and at least three growing folliclesor = 20 mm in diameter were present. Fertilization failure was noted in six couples and in another 10 cases freezing of all embryos was decided, therefore embryo transfer was performed on 96 patients. There were 31 clinical pregnancies (five twins) giving a pregnancy rate per patient and per embryo transfer of 30.4% and 32.3%, respectively, with an implantation rate of 18.1%. With regard to all 112 coasted patients, six developed moderate and two severe OHSS. This study shows that withholding gonadotropin administration in high-risk IVF patients results in a good cycle outcome and a very low risk of severe OHSS, and also demonstrates the importance of both the timing of coasting initiation and the timing of hCG administration. |
| Databáze: | OpenAIRE |
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