Luteolysis induced by a gonadotropin-releasing hormone agonist is the key to prevention of ovarian hyperstimulation syndrome.

OBJECTIVE To review the available knowledge on the use of GnRH agonist for ovulation triggering as a means to prevent ovarian hyperstimulation syndrome (OHSS). DESIGN(S) Review of pertinent English language studies published over the past 15 years. RESULT(S) The available literature suggests that while GnRH agonist effectively induces final oocyte maturation and ovulation, it also completely and reliably prevents clinically significant OHSS. The mechanism of action in the context of OHSS prevention involves complete, quick, and irreversible luteolysis CONCLUSION(S) Controlled ovarian stimulation protocols based on GnRH antagonist to prevent premature LH rise and GnRH agonist for ovulation triggering provide a safe and OHSS-free clinical environment. Adequate luteal support compensates for luteolysis and assures good clinical outcome. The fertility community is urged to adopt these protocols. This will make OHSS a disease of the past.