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Ganirelix is a subcutaneously administered third generation synthetic gonadotropin-releasing hormone (GnRH) antagonist. This drug has a number of advantages compared with the currently used GnRH agonists, including immediate suppression of luteinising hormone (LH) and a lower risk of developing ovarian hyperstimulation syndrome. In women undergoing in vitro fertilisation (IVF), ganirelix 0.25 mg/day was associated with suppression of endogenous LH surges and good clinical outcomes (in terms of pregnancy rates) in a large multicentre dose-finding trial. Whether ganirelix compromises IVF outcome and whether pregnancy rates are greater with this drug than with standard protocols are yet to be determined.