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Steril 2010;93:847–854. Humaidan P, Polyzos NP, Alsbjerg B, Erb K, Mikkelsen AL, Elbaek HO, Papanikolaou EG, Andersen CY. (2013) GnRH agonist trigger and individualized luteal phase hCG support according to ovarian response to stimulation—two multi-centre RCTs in IVF patients. Hum Reprod 2013;28:2511–2521. Papanikolaou EG, Pozzobon C, Kolibianakis EM, Camus M, Tournaye H, Fatemi HM, Van SA, Devroey P. Incidence and prediction of ovarian hyperstimulation syndrome in women undergoing gonadotropinreleasing hormone antagonist in vitro fertilization cycles. Fertil Steril 2006; 85:112–120. Seyhan A, Ata B, Polat M, Son WY, Yarali H, Dahan MH. Severe early ovarian hyperstimulation syndrome following GnRH agonist trigger with the addition of 1500 IU hCG. Hum Reprod 2013;28:2522–2528.

Reply: GnRHa trigger and modified luteal support with one bolus of hCG should be used with caution in extreme responder patients