A case is reported of early onset ovarian hyperstimulation syndrome (OHSS) after gonadotrophin-releasing hormone agonist (GnRHa) trigger for final oocyte maturation in a GnRH antagonist protocol. The use of GnRHa in place of HCG as a trigger for final oocyte maturation in an antagonist IVF cycle has been proposed as a method for preventing OHSS in predicted high-responders. This approach, however, did not prevent the occurrence of OHSS in our case despite a freeze-all strategy. To the best of our knowledge, this is a possible index case of severe OHSS with GnRHa trigger for oocyte maturation without any luteal HCG rescue for a high responder, despite IVF cycle segmentation.
Ling, L. P., Phoon, J. W. L., Lau, M. S. K., Chan, J. K. Y., Viardot-Foucault, V., Tan, T. Y., … Tan, H. H. (2014). GnRH agonist trigger and ovarian hyperstimulation syndrome: Relook at “freeze-all strategy.” Reproductive BioMedicine Online, 29(3), 392–394. https://doi.org/10.1016/j.rbmo.2014.05.012