GnRH agonist for triggering final oocyte maturation: time for a critical evaluation of data

Sir, We read with great interest the manuscript by Humaidan et al. (2011). In this review, the authors summarize the published evidence regarding the use of GnRH agonist for triggering final oocyte maturation in patients undergoing IVF. By combining the results of six recently published randomized controlled trials (RCTs), the authors suggest that when a modified luteal phase support (LPS) is employed, following GnRH agonist triggering, pregnancy rates are comparable with those achieved after hCG triggering and standard LPS. Moreover, they suggest that GnRH agonist triggering combined with a modified LPS results in elimination of ovarian hyperstimulation syndrome (OHSS). These findings are very interesting, since they support the notion that GnRH agonist triggering when combined with a modified LPS is both an effective and safe treatment. We would like to elaborate on the data presented by the authors and extend the implications of the available evidence on the efficacy and safety of GnRH agonist triggering.