Document Detail


The effect of duration of coasting and estradiol drop on the outcome of assisted reproduction: 13 years of experience in 1,068 coasted cycles to prevent ovarian hyperstimulation.
MedLine Citation:
PMID:  19939366     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the effect of duration of coasting (Cd), estradiol levels at trigger (E(2)), and level of estradiol drop (E(2)d) on live birth rate (LBR) in cycle outcome. DESIGN: Retrospective analysis. SETTING: Hospital-based fertility clinic. PATIENT(S): A total of 1,068 coasted cycles (5.7% of total) of IVF/ICSI from 1996 to 2008. INTERVENTION(S): Coasting in IVF/ICSI cycles. MAIN OUTCOME MEASURE(S): Live birth rate and secondary cycle outcomes. RESULT(S): Mean Cd, E(2), and E(2)d were 4.7 days, 11,567 pmol/L, and 9,760 pmol/L, respectively. Maternal age, duration of subfertility, and serum FSH were significantly lower, and AMH (39.7 vs. 15.1 pmol/L) and prevalence of polycystic ovary syndrome (31.8% vs. 17.8%) significantly higher, in coasted cycles. Fertilization rate, clinical pregnancy rate, and LBR per cycle and implantation rate of 64.4%, 40.7%, 35.7%, and 24.7%, respectively, were demonstrated, with no significant difference in LBR in cycles coasted for up to 8 days or when divided according to E(2) or E(2)d. Lack of predictive capability on LBR was confirmed by receiver operator curve analysis which demonstrated areas under the curve of 0.51, 0.53, and 0.54 for E(2), Cd, and E(2)d, respectively. CONCLUSION(S): Although cycle numbers beyond 6 days are limited, coasting for up to 8 days does not affect LBR, and E(2) and E(2)d levels do not significantly affect cycle outcome.
Authors:
Hossam Abdalla; James D M Nicopoullos
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Publication Detail:
Type:  Journal Article     Date:  2009-11-25
Journal Detail:
Title:  Fertility and sterility     Volume:  94     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-27     Completed Date:  2010-11-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1757-63     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Lister Fertility Clinic, Lister Hospital, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adult
Chorionic Gonadotropin / pharmacology*
Estradiol / metabolism*
Female
Fertilization in Vitro / methods
Humans
Outcome Assessment (Health Care)
Ovarian Follicle / drug effects*,  metabolism
Ovarian Hyperstimulation Syndrome / prevention & control*
Pregnancy
Pregnancy Rate*
ROC Curve
Reproductive Techniques, Assisted*
Retrospective Studies
Sperm Injections, Intracytoplasmic / methods
Time Factors
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 50-28-2/Estradiol

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


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