In controlled ovarian stimulation for IVF, the OHSS prevention strategy of triggering with GnRH agonist (instead of hCG) is applicable in which protocol?

• A Long GnRH agonist down-regulation protocol
• B Clomiphene citrate + gonadotrophin protocol
• C GnRH antagonist protocol ✓
• D Natural cycle IVF protocol

Explanation

GnRH agonist trigger (e.g., leuprolide or buserelin) for final oocyte maturation is effective only in GnRH antagonist protocols, as the pituitary is not suppressed and can respond to the agonist bolus with an endogenous LH/FSH surge. In long agonist protocols (where the pituitary is deeply suppressed by prolonged agonist exposure), a GnRH agonist trigger will not produce an adequate LH surge. GnRH agonist trigger followed by a freeze-all strategy virtually eliminates early-onset OHSS.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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