Does freeze all policy eliminate OHSS??? “It ain’t necessarily so…”

Small follicles may be a promising source of oocytes in modified natural cycle in vitro fertilization–embryo transfer

“…To overcome this problem, triggering with human chorionic gonadotropin (hCG) may be preferable to GnRHagonist triggering in a natural or very mild stimulation cycle. The agonist trigger is usually used in cases where late follicular high estradiol levels are measured and/or many follicles are visualized on ultrasound to minimize the risk of ovarian hyperstimulation syndrome (OHSS) (2,3). Its advantage in a natural cycle has not been unequivocally demonstrated.…”

“…On the other hand, it has been shown that the pregnancy rate increases up to retrieval of 10 oocytes, plateaus between 10 and 15, and decreases thereafter when more than 15 oocytes are retrieved (2,4). A possible compromise would be retrieval of four to six oocytes, which will enable a good pregnancy rate and minimize the risk of OHSS and patient discomfort, while keeping the endometrium in phase and enabling fresh single blastocyst transfer with a high implantation rate (2)(3)(4).…”