Agonist and antagonist coast

GnRH Analogues in the Prevention of Ovarian Hyperstimulation Syndrome

“…The problem lies in the fact that the review included only four studies, all of which were very different to each other (two studies compared coasting with unilateral follicular aspiration (52), one compared coasting with the replacement of the GnRH agonist with a GnRH antagonist (49), and the last one compared coasting versus no coasting (53). For this reason, the authors concluded that there was no evidence to suggest the benefit of using coasting to prevent OHSS if compared to not using it (or other interventions), and clinicians should use other strategies to lower the incidence of severe OHSS (54, 55). …”

Ovarian Hyperstimulation Syndrome

“…17 This was largely due to the increased dose of gonadotropins required for stimulation and in some part due to prevention of atresia of smaller antral follicles due to pituitary downregulation. 18 The GnRH antagonist protocol has two advantages over agonist, one pituitary suppression is started after stimulation thus, lower doses of gonadotropins can be used and two GnRHa trigger can be used for final oocyte maturation.…”

Retrieving oocytes from small non-stimulated follicles in polycystic ovary syndrome (PCOS): in vitro maturation (IVM) is not indicated in the new GnRH antagonist era

“…First, the risk of OHSS is reduced in COS protocols using GnRH antagonists for preventing premature luteinization as compared with the classical GnRH-a protocols (30). Second, the antagonists protocols have revived the possibility of triggering ovulation with GnRH-a (31) instead of hCG, as first reported two decades ago in non-suppressed cycles (32)(33)(34)(35).…”