Coasting Versus GnRH Antagonist administration in Patients at High Risk of Ovarian Hyper stimulation Syndrome and its impact on the ICSI Outcome

Document Type : Original Article

Author

International Islamic Centre for Population Studies and Researches (IICPR) Al-Azhar University,

Abstract

Objectives: study the value of GnRH antagonist administration as an alternative protocol to coasting in preventing
severe OHSS in cases of long agonist ovarian stimulation protocol and its impact on embryos quality &positive
pregnancy in women undergoing ICSI.
Study design: A prospective randomized control trial is
done at the assisted Reproduction unit, Al-Azhar university, Egypt to compare Coasting group (n = 150) and GnRH
antagonist group (n = 150) in patients detected to be at
risk of OHSS during the process OHSS in cases of long
agonist ovarian stimulation protocol before ICSI. The primary outcome was high quality embryos, the secondary
outcome was days of intervention, number of oocytes,
pregnancy outcome, number of cryopreserved embryos
and incidence of severe OHSS.
Results: There were statistical significant deference between quality embryos (2.3±1.2 versus 1.6±0.7; P value = 0.001) and more oocytes number (8.2±3.1) versus
(6.7±3.2; P value = 0.01) in Antagonist group as compared with coasting group. There were more number of
coasting days than with antagonist administration days
(2.9±1.4 versus 2.2±1.1; P value = 0.001).
Conclusion: GnRH antagonist was superior to coasting in
producing higher numbers of mature oocytes, high quality embryos and reducing the number of days till the HCG
injection. There was no statistical significant difference in
chemical pregnancy rate between two groups. No early
or late OHSS developed in either group.

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