Ovarial hyperstimulation by ART. The current situation

Treatment's success using ART mainly depends on the quality of ovarian stimulation. The possibility of avoiding premature luteinization of growing follicles during stimulation by using GnRH agonists was a major milestone. Nowadays, GnRH antagonists are also available on the market, making stimulation less time consuming and easier to handle. However, whether GnRH antagonists, in terms of pregnancy rates and treatment outcome, are equivalent to GnRH agonists in the so called "long" protocol is not yet clear. Very recent analyses based on data from the German National IVF registry (DIR) on more than 1,800 cycles in young patients with a clearly defined profile (age<35 years, first treatment cycle, pure tubal infertility, only classical IVF) could not demonstrate any differences in pregnancy rates between GnRH antagonists and GnRH agonists. These data seem to indicate that GnRH antagonists should be used as the "first choice treatment" in ovarian stimulation.