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Coasting

By: jehad yousef, private clinic
19 July 2009
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Question:

I have 32 ys old patient with PCO and history of severe OHSS following HMG/IUI before three years ;  was admitted to  to ivf programme, on long protocol and was given decapeptyl 3.75 mg on cycle day one, 14 days later after conferming downregulation was started on HMG 150 U daily, On stimulation day 6 estradiol level was 620 pgm and 12 follicles in each ovary 9-10 mm, HMG dose was reduced to 75 U, on days 7,8 and on day 9 there were 28 follicles, leading 16 mm and estradiol 4420, was coasted and estradiol increased to 6342 on day 10 and 7150 on day 11. today (day 12) estradiol decreased to 5200, shall i contiue till estradiol decreases to <3000 and proceed with HCG, OR give the HCG at this stage and consider preventive measures (iv albumen, DOSTINEX), many follicles are now 16-19 mm. ANY SUGGESTIONS ??.noting that our freezing proramme is not  very efficient. THANKS.

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