Document Detail

Coasting-what is the best formula?
MedLine Citation:
PMID:  12721165     Owner:  NLM     Status:  MEDLINE    
Coasting is a method to decrease the incidence of ovarian hyperstimulation syndrome (OHSS), which involves withdrawing exogenous gonadotrophins until the serum estradiol (E(2)) level decreases. The application of this strategy, as it appears in the literature, has been variable, with heterogeneous criteria for initiating and ending the coasting process and as a result, reports of efficacy are inconsistent. In attempt to establish a recommended protocol for coasting we reviewed and analysed 10 relevant studies, found by a Medline search. Based on the data collected, coasting should be initiated when the serum E(2) concentration exceeds 3000 pg/ml, but not unless the leading follicles reach a diameter of 15-18 mm. Its duration should be limited to <4 days, thus, preventing the decrease in implantation and pregnancy rates that occur after longer periods of coasting. Administration of hCG should be withheld until serum E(2) falls below 3000 pg/ml. Based on the published data, these suggested guidelines result in an acceptably low incidence of severe OHSS (<2%) and provide satisfactory fertilization and pregnancy rates (55-71% and 36.5-63% respectively). A multicentre randomized prospective study would help to confirm the effectiveness of this approach.
O Levinsohn-Tavor; S Friedler; M Schachter; A Raziel; D Strassburger; R Ron-El
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  18     ISSN:  0268-1161     ISO Abbreviation:  Hum. Reprod.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-04-30     Completed Date:  2004-01-14     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  England    
Other Details:
Languages:  eng     Pagination:  937-40     Citation Subset:  IM    
IVF and Infertility Unit, Department of Obstetrics and Gynecology, Assaf-Harofeh Medical Center, Zerifin, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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MeSH Terms
Chorionic Gonadotropin / administration & dosage*
Drug Administration Schedule
Estradiol / blood*
Gonadotropins / administration & dosage*
Ovarian Hyperstimulation Syndrome / prevention & control*
Ovulation Induction / methods*
Treatment Outcome
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/Gonadotropins; 50-28-2/Estradiol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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