coasting valuable in all patients with any cause of infertility?

Objectives: This study aimed to assess the influence of coasting duration on the number and quality of oocytes and fertilization rate in male factor infertile women and those with polycystic ovary syndrome [PCOS]

Methods: In this prospective observational follow-up study, 114 patients undergoing coasting [53 women with male factor infertility and 61 women with PCOS] were evaluated at the Royan Institute Research Center, Iran, between 2010 and 2012

Results: The results were analyzed according to the coasting periods of 1-4 days. In normal females, the number of oocytes retrieved was significantly reduced after the second day [p = 0.004]. In addition, a statistically significant drop was observed in the number of metaphase II oocytes and fertilization rate after the third day [p = 0.006 and p = 0.006, respectively]. No significant differences were observed in the number and quality of oocytes retrieved and fertilization rate with regard to coasting days in PCOS patients

Conclusion: Coasting with duration of more than three days should be performed with caution in normal females who are at risk of developing ovarian hyperstimulation syndrome

Comparison of easy and difficult embryo transfer outcomes in in vitro fertilization cycles

The aim of this study was to compare the effects of easy and difficult embryo transfers [ET] on implantation and pregnancy rates. In this prospective study, we analyzed the results of 706 ET procedures over a 12-month period. An easy ET was defined as a transfer that occurred without the use of force or other instrumentation. A difficult ET was defined as the use of force for catheter placement, and/or the use of additional instruments, and/or manipulation. Pregnancy rate was compared between patients with easy or difficult ETs. There was a significantly higher implantation rate in the easy group [21.7%] compared to the difficult group [12.1%, p<0.05].The easy group had a higher pregnancy rate [38.1%] compared to patients who had difficult ETs [21.4%; p<0.05]. Any uterine manipulation during ET adversely affects in vitro fertilization [IVF]. Precaution should be taken to identify possibly difficult ET cases in advance