[Coasting: a response to excessive ovarian stimulation]

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization

Background:

• Ovarian hyperstimulation treatment enhances in vitro fertilization (IVF) success rates.
• However, excessive response to ovarian hyperstimulation increases risks of complications and cycle cancellation.
• Careful patient evaluation is crucial to mitigate the risk of ovarian hyperstimulation syndrome (OHSS).

Purpose of the Study:

• To evaluate the efficacy and safety of the coasting method in managing excessive ovarian response during IVF protocols.
• To assess the impact of coasting on pregnancy rates and oocyte quality.
• To determine if coasting can reduce OHSS risk without compromising IVF outcomes.

Main Methods:

• The coasting method involves temporarily halting gonadotropin administration while continuing GnRH agonist therapy.
• hCG administration is resumed only after estradiol levels decrease.
• This strategy is implemented when an excessive ovarian response is detected during IVF stimulation.

Main Results:

• Literature review indicates adequate pregnancy rates ranging from 26% to 64% with the coasting method.
• Oocyte quality appears to be preserved despite the coasting intervention.
• The coasting method did not definitively eliminate the risk of OHSS but helped manage excessive response.

Conclusions:

• Coasting is a potentially safe and efficient method for managing excessive ovarian response in IVF.
• This technique may help preserve pregnancy rates while mitigating risks associated with hyperstimulation.
• Further evaluation is needed to fully understand OHSS risk reduction with coasting.