Journal of Human Reproductive Science
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ORIGINAL ARTICLE Table of Contents   
Year : 2012  |  Volume : 5  |  Issue : 1  |  Page : 32-36
Prediction of ovarian hyperstimulation syndrome in coasted patients in an IVF/ICSI program


1 Consultant Obstetrician and Gynaecologist, Alyamamah Hospital, Riyadh, Saudi Arabia
2 Senior Lecturer in Medical Statistics, School of Clinical Sciences, University of Bristol Institute of Child Life and Health, UBHT Education Centre, Bristol, United Kingdom
3 Consultant Gynaecologist and Subspecialist in Reproductive Medicine, Bristol Centre for Reproductive Medicine, Southmead Hospital, Bristol, United Kingdom

Correspondence Address:
Fatimah Y Aljawoan
P.O. Box 225151, Riyadh 11324
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-1208.97795

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Aim: To determine why a subgroup of coasted patients developed moderate/severe ovarian hyperstimulation syndrome (OHSS) in an assisted reproduction setting. Materials and Methods: Retrospective study of 2948 in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment cycles with 327 patients requiring coasting. Long protocol gonadotrophin releasing hormone analogue (GnRH-a) regimen was used and serum estradiol (E 2 ) checked when ≥20 follicles were noted on follicular tracking. Coasting was initiated when leading three follicles were ≥15mm with E 2 ≥1635pg/ml. Results: The incidence of moderate/severe OHSS was 10.4% in coasted patients (equivalent 1.15% of the total IVF/ICSI cycles in the Center). Coasted patients who subsequently developed OHSS showed a significantly higher number of retrieved oocytes, higher serum E 2 level on the day of human chorionic gonadotrophin (hCG) administration, and multiple pregnancies. No significant differences were noted with female age, BMI, cause of infertility, gonadotrophin dosage, coasting duration, and % of E 2 drop. Conclusion: Moderate/severe OHSS might be predicted in coasted patients by a combination of total oocyte numbers and E 2 level on the day of hCG. Multiple pregnancies also significantly increased the risk.


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