Value of measuring serum FSH in addition to serum estradiol in a coasting programme to prevent severe OHSS

• Published in: Human reproduction (Oxford) 2002-05, Vol.17 (5), p.1217-1221
• Main Authors: Al-Shawaf, T., Zosmer, A., Tozer, A., Gillott, C., Lower, A.M., Grudzinskas, J.G.
• Format: Article
• Language: English
• Subjects: Adult; assisted reproduction; Biological and medical sciences; coasting; Estradiol - blood; Female; Follicle Stimulating Hormone - blood; Fundamental and applied biological sciences. Psychology; Hormone metabolism and regulation; Humans; Incidence; Mammalian female genital system; OHSS; Ovarian Hyperstimulation Syndrome - epidemiology; Ovarian Hyperstimulation Syndrome - prevention & control; Preventive Medicine - methods; Prospective Studies; serum estradiol; serum FSH; Vertebrates: reproduction
• ISSN: 0268-1161; 1460-2350; 1460-2350
• DOI: 10.1093/humrep/17.5.1217

BACKGROUND: Withholding gonadotrophins (coasting) can reduce the risk of severe ovarian hyperstimulation syndrome (OHSS) in patients having assisted reproduction therapy. This requires daily serum estradiol (E2) measurements, which occasionally have been seen to decline suddenly and sharply. METHODS: To increase the sensitivity of the coasting programme we measured serum FSH in parallel with E2 in patients at risk of developing OHSS. RESULTS: Out of a total of 1240 cycles, 106 were coasted and in 89 both serum E2 and FSH were measured at least twice during the coasting period. One case of late severe OHSS was encountered in the study group. The serum FSH declined by a rate of 24.3 ± 4.5% per day. Serum E2 level reached a `safe level' of