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Fischer, R., Nakano, F.Y., Roque, M., Bento, F.C., Baukloh, V. and Esteves, S.C. (2019) A Quality Management Approach to Controlled Ovarian Stimulation in Assisted Reproductive Technology: The “Fischer Protocol”. Panminerva Medica, 61, 11-23.
https://doi.org/10.23736/S0031-0808.18.03549-8

has been cited by the following article:

• TITLE: Follicular Aspiration Is Superior to Coasting as Effective Prophylactic Procedure against Ovarian Hyperstimulation Syndrome

  AUTHORS: Walid Mohamed Elnagar, Huda Fathy Ebian

  KEYWORDS: Ovarian Hyperstimulation Syndrome, PCOS, Follicular Aspiration, Coasting Procedure

  JOURNAL NAME: Open Journal of Obstetrics and Gynecology, Vol.9 No.5, May 22, 2019

  ABSTRACT: Objectives: Evaluation of outcome follicular aspiration compared to coating procedure for infertile women undergoing ICSI regarding frequency and severity of ovarian hyperstimulation syndrome (OHSS). Patients & Methods: Infertile PCOS women underwent controlled ovarian stimulation with luteal phase GnRH-agonist long down-regulation protocol. Women developed serum E2 level > 4000 pg/ml and/or >20 follicles of ≥10 mm in diameter were randomly divided to receive coasting strategy (Coasting group) or TVU-guided aspiration (Aspiration group). When ≥3 follicles were ≥18 mm and serum E2 level was and 10,000 IU was administered 36 h before oocyte retrieval, and ICSI was performed 72-hr thereafter and the frequency of moderate-to-severe OHSS was determined. Results: 82 women developed criteria for categorization and 21 women (25.6%) developed moderate-to-severe OHSS; 5 women of aspiration and 16 of Coasting group; with significantly (P = 0.005) lower frequency in aspiration group. Twenty women developed ascites; 3 women had clinically detectable, while 17 women had US detected ascites with significantly (P = 0.039) higher frequency among women that had coasting. All other manifestations of OHSS were significantly lower with aspiration procedure. Both coasting and aspiration therapy significantly reduced serum E2 and ovarian diameter on day of hCG injection compared to estimates taken at time of categorization. Conclusion: Coasting procedure prior to hCG injection could decrease incidence of OHSS and lessens its manifestation. Follicular aspiration provided more superior results and improved outcome of these women. Any of these modalities could be provided to infertile high-risk women according to the availability of experiences and patients’ selection.