In this review the advantages of the gonadotropin-releasing hormone agonist (GnRHa) trigger are discussed beyond those immediately associated with ovarian hyperstimulation syndrome (OHSS) prevention. The GnRHa trigger concept has sparked the development of novel protocols, enriching the assisted reproductive technology (ART) armamentarium for the benefit of present and future patients. Thus, GnRHa trigger already has a pivotal role, not only for the standard in vitro fertilisation (IVF) patient, but also for patient groups like oocyte donors, cancer patients, patients with poor ovarian reserve, and patients with immature oocyte syndrome and empty follicle syndrome. Herein, we discuss the importance of the GnRHa-elicited midcycle FSH surge and the potential improvement in oocyte yield and embryo competence.

The introduction of gonadotrophin-releasing hormone agonist (GnRHa) trigger greatly impacted modern IVF treatment. Patients at low risk of ovarian hyperstimulation syndrome (OHSS) development, undergoing fresh embryo transfer and GnRHa trigger can be offered a virtually OHSS-free treatment with non-inferior reproductive outcomes by using a modified luteal phase support in terms of small boluses of human chorionic gonadotrophin (hCG), daily recombinant luteinizing hormone LH (rLH) or GnRHa. In the OHSS risk patient, GnRHa trigger can safely be performed, followed by a 'freeze-all' policy with a minimal risk of OHSS development and high live birth rates in the subsequent frozen embryo transfer cycle. Importantly, GnRHa trigger opened the 'black box' of the luteal phase, promoting research in the most optimal steroid levels during the luteal phase. GnRHa trigger allows highdose gonadotropin stimulation to achieve the optimal number of oocytes and embryos needed to ensure the highest chance of live birth. This review thoroughly discusses how the GnRHa trigger concept adds safety and efficacy to modern IVF in terms of OHSS prevention. Furthermore, the optimal luteal phase management after GnRHa trigger in fresh embryo transfer cycles is discussed.

NIPT introduction has caused a significant reduction of 60.5% of IP in high chromosomopathy risk patients after combined screening without modifying detection rate.

The frequency of spontaneous abortion, when it is considered from its very beginning, along with the theoretical knowledge of the causes of the abortion, should provide a perspective to the obstetrician that, performing a sonographic exploration finds discoveries that cannot correspond to those characterizing a normal pregnancy. The precocity of the realization of sonographic explorations in the pregnancy will allow diagnosis of many more cases of spontaneous interruptions of the development of pregnancy. New sonographic imaging techniques including three-dimensional (3D) sonography can provide additional information regarding the presence of structural anomalies via 3D volume acquisition, like craniofacial deformities, clefts, neural tube defects, abdominal wall defects, and caudal regression syndrome. It may give further details regarding the timing of embryonic/fetal demise in early pregnancy. Sufficient informational value is regularly obtained in cases having a crown-rump length >8 mm. How to cite this article Serrano-González L, Martinez-Moya M, Platero-Mihi M, Bajo-Arenas J, Perez-Medina T. Ultrasonographic Signs of Poor Pregnancy Outcome. Donald School J Ultrasound Obstet Gynecol 2017;11(1):44-58.