Abstract

Ovarian hyperstimulation syndrome (OHSS) is a serious complication of ART which occurs more frequently in women with a high absolute or rapidly rising serum estradiol (E2) level or more than 25 follicles. Some have proposed withholding gonadotropins (coasting) as one strategy to reduce the likelihood of OHSS. We have reported the novel addition of GnRH antagonist to women suppressed with GnRH agonists as an alternate to coasting in a pilot study of 12 patients with ovarian hyperresponse. In these women treated with GnRH agonist, addition of GnRH antagonist resulted in a 35% reduction in E2 within 24 hours, allowed cycle continuation, and resulted in excellent pregnancy outcome without excess incidence of OHSS.

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