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Human Reproduction, Vol. 17, No. 5, 1217-1221, May 2002
© 2002 European Society of Human Reproduction and Embryology

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

T. Al-Shawaf1,3, A. Zosmer1, A. Tozer1, C. Gillott1, A.M. Lower1 and J.G. Grudzinskas1,2

1 St Bartholomew's and The London NHS Trust, Reproductive Medicine Centre, 2nd Floor KGV Block, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE and 2 Department of Obstetrics and Gynaecology, St Bartholomew's and The Royal London School of Medicine and Dentistry, St Bartholomew's Hospital, London, UK

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 <10 000 pmol/l when the serum FSH declined to 5 IU/l or less. CONCLUSION: The results from this study show that measuring serum E2 and FSH can assist in predicting the point at which serum E2 has declined to a level safe enough to administer the trigger HCG.

Key words: assisted reproduction/coasting/OHSS/serum estradiol/serum FSH

3 To whom correspondence should be addressed. E-mail: talhayas{at}aol.com


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R. Mansour, M. Aboulghar, G. Serour, Y. Amin, and A. M. Abou-Setta
Criteria of a successful coasting protocol for the prevention of severe ovarian hyperstimulation syndrome
Hum. Reprod., November 1, 2005; 20(11): 3167 - 3172.
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