Severe ovarian hyperstimulation syndrome after gonadotropin-releasing hormone (GnRH) agonist trigger and "freeze-all" approach in GnRH antagonist protocol.

To report two cases with GnRH agonist triggering and a freeze-all approach in a GnRH antagonist protocol resulting in the development of severe ovarian hyperstimulation syndrome (OHSS), requiring hospitalization and peritoneal drainage. Two case reports. A tertiary referral center and an obstetrics and gynecology department of a hospital. Case 1 and case 2: severe OHSS with abdominal distension, ascites development, and hemoconcentration. Case 1 and case 2: diagnosed by clinical, hematologic, and ultrasound findings. Hospitalization, IV infusion, and peritoneal drainage. Symptomatic treatment and prevention of further complication. Complete recovery. Two cases of severe OHSS after GnRH agonist trigger in a GnRH antagonist protocol without the administration of any hCG for luteal-phase support. Clinicians have to be aware that even the sequential approach to ovarian stimulation with a freeze-all attitude does not completely eliminate OHSS in all patients.

Fatemi HM ，Popovic-Todorovic B ，Humaidan P ，Kol S ，Banker M ，Devroey P ，García-Velasco JA ... -  《-》

Severe early ovarian hyperstimulation syndrome following GnRH agonist trigger with the addition of 1500 IU hCG.

Seyhan A ，Ata B ，Polat M ，Son WY ，Yarali H ，Dahan MH ... -  《-》

Severe ovarian hyperstimulation syndrome following sole gonadotropin-releasing hormone (GnRH) agonist trigger: a case series and literature review.

Berkovitz-Shperling R ，Samara N ，Meir R ，Dominsky O ，Azam F ，Feferkorn I ... -  《-》

Severe early ovarian hyperstimulation syndrome following GnRH agonist trigger and freeze-all strategy in GnRH antagonist protocol; case report and literature review.

Hajizadeh N ，Hosseini S ，Salehpour S ，Abbasi H ，Saheb J ... -  《-》

GnRH antagonist rescue of a long-protocol IVF cycle and GnRH agonist trigger to avoid ovarian hyperstimulation syndrome: three case reports.

To describe three clinical cases involving patients at high risk of severe ovarian hyperstimulation syndrome (OHSS) during IVF stimulation. Description of clinical management of IVF cycles and outcomes in patients at risk of developing OHSS. Reproductive medicine unit, private hospital. Three infertile patients undergoing stimulation for IVF/intracytoplasmic sperm injection presenting high risk of OHSS. IVF patients treated under long protocol presenting high risk of OHSS had their cycles rescued by withdrawing the agonist and replacing it with an antagonist and triggering ovulation with an agonist bolus. OHSS symptoms, pregnancy. None of the three patients developed OHSS. One patient got pregnant after fresh embryo transfer, one patient got pregnant after frozen embryo transfer, and one patient had no oocytes retrieved despite the detection of LH in urine after the GnRH bolus. When a patient undergoing an IVF cycle with long protocol is at high risk of severe OHSS, rescuing the cycle by withdrawing the agonist and replacing it with an antagonist and triggering ovulation with an agonist bolus could be considered without jeopardizing the safety of the patient while retaining the opportunity for success of the cycle. Further broader studies are needed.

Martínez F ，Rodríguez DB ，Buxaderas R ，Tur R ，Mancini F ，Coroleu B ... -  《-》