Early ovarian hyperstimulation syndrome is completely prevented by gonadotropin releasing-hormone agonist triggering in high-risk oocyte donor cycles: a prospective, luteal-phase follow-up study

Ovarian hyperstimulation syndrome after gonadotropin-releasing hormone agonist triggering and “freeze-all”: in-depth analysis of genetic predisposition

“…However, OHSS still occurs in current clinical practice [14] and its overall importance increases with the steady worldwide proliferation of IVF. GnRH agonist ovulation triggering has contributed to the further reduction of severe OHSS [37,10,15,14] and, in conjunction with elective cryopreservation of all viable embryos, is considered to be the safest way to avoid OHSS after OS for IVF [38,12,14]. In view of this, elective cryopreservation of embryos has been proposed for women undergoing IVF/ICSI who develop ≥18 follicles with a diameter of at least 10-14 mm [39] to minimize the risk of the development of severe OHSS.…”

“…In a GnRH antagonist co-treated cycle, the GnRH agonist causes the displacement of the GnRH antagonist from the pituitary receptors, resulting in a LH flare-up/Bsurget hat lasts for approximately 24-36 h [7]. This approach, combined with the elective cryopreservation of all oocytes/embryos, referred to by some as the BOHSS-free clinic^ [14], had effectively abolished the incidence of severe early OHSS [14,15,10] until recently, when the first cases of OHSS requiring hospitalization were reported [16][17][18][19]. These cases include both patients with either grade 4 (3 cases) and grade 5 (4 patients) severe early-onset OHSS according to the OHSS classification proposed by Golan et al [adopted by the European Society of Human Reproduction and Embryology (ESHRE)] [20].…”

Empty follicle syndrome after GnRHa triggering versus hCG triggering in COS

“…In our study, as expected, the donor population was younger and had higher estradiol levels as well as a higher number of eggs retrieved. On the other hand, these discordances between groups, albeit significant, do not defeat the purpose of the study because the physiological action of a bolus of GnRHa on the pituitary to induce final follicular maturation in GnRH antagonist cycles is independent of age, type of COS and even ovarian response, as described in ovulation induction cycles [17,18] normoresponder IVF patients [19] hyperresponder patients [20] as well as donor population [21]. Hence, there is no reason to presume that GnRHa for triggering may act differently in donors and IVF patients.…”

Transvaginal versus transabdominal ultrasound guidance for embryo transfer in donor oocyte recipients: a randomized clinical trial

“…The donors' ovarian stimulation was conducted with a gonadotropinreleasing hormone (GnRH) antagonist protocol coupled with GnRH agonist triggering (14). Before treatment, careful clinical assessment was carried out in oocyte recipient candidates.…”