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A gonadotropin-releasing hormone agonist trigger in an antagonist IVF cycle can markedly reduce the risk of ovarian hyperstimulation syndrome compared with traditional hCG triggering, particularly in patients at high risk. Randomized evidence supports the strategy when fresh embryo transfer is not immediately required or when adequate luteal support and a freeze-all approach are available. For reproductive specialists, this is an important example of tailoring the stimulation protocol to prevent avoidable complications rather than treating OHSS after it develops. Patient selection, luteal-phase management and clinic experience with cryopreservation are important. The approach is especially relevant for women with PCOS or very high follicle counts.
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A gonadotropin-releasing hormone agonist trigger in an antagonist IVF cycle can markedly reduce the risk of ovarian hyperstimulation syndrome compared with traditional hCG triggering, particularly in patients at high risk. Randomized evidence supports the strategy when fresh embryo transfer is not immediately required or when adequate luteal support and a freeze-all approach are available. For reproductive specialists, this is an important example of tailoring the stimulation protocol to prevent avoidable complications rather than treating OHSS after it develops. Patient selection, luteal-phase management and clinic experience with cryopreservation are important. The approach is especially relevant for women with PCOS or very high follicle counts.
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