Introduction: Gonadotropin-releasing hormone agonist triggering of final follicular maturation for in vitro fertilization.

These Views and Reviews articles examine the use of GnRH agonist for triggering the final stage of follicular maturation in IVF, resulting in excellent follicle maturation. An advantage of the GnRH agonist trigger is the ability to retrieve oocytes in high responders, yet markedly reducing the risk of ovarian hyperstimulation syndrome (OHSS). However, the induction of early luteolysis after the GnRH agonist trigger requires the use of aggressive steroidal luteal support or low-dose hCG to allow successful fresh ET and live birth. With the enhanced effectiveness of vitrification, segmentation in GnRH agonist-triggered cycles with freezing all embryos for transfer in subsequent cycles may be the optimal strategy for eliminating OHSS.