Human chorionic gonadotropin versus gonadotropin releasing hormone agonist trigger in assisted reproductive technology The king is dead long live the king

Peter Humaidan, M.D., D.M.Sc., Nikolaos Polyzos, M.D., Ph.D.

Volume 102, Issue 2, Pages 339–341

In this Conceptions piece, we set out to explore whether current scientific evidence supports the future use of a GnRH-a trigger in all IVF patients co-treated with a GnRH antagonist, regardless of ovarian response on the day of trigger. The studies examined, our own and those of others, provide evidence that this is a helpful approach. The GnRH-a trigger has offered an important insight into the early/mid luteal phase, which allows for a tailored approach to LPS, taking into account the ovarian response to stimulation of each individual patient. We predict that in near future the frequently used term “standard LPS” will be replaced by “tailored LPS,” similar to the tailored approach to ovarian stimulation. The clear benefit of a GnRH-a trigger is that it leaves the clinician with several options for handling a patient’s case. Thus, in patients with an extreme response to stimulation, a GnRH-a trigger followed by a “freeze-all” strategy is an optimal tool to eliminate OHSS.

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