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The 2020 guideline from European Society of Human Reproduction and Embryology (ESHRE) recommends the use of GnRH\u2010ant for patients with varying levels of ovarian response. However, the question of how to manage the protocol pathway for these patients requires further investigation.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> The current clinical practice guideline (CPG) adheres to the World Health Organization's (WHO) recommended development process, and covers eight clinical questions, all focusing on the application of GnRH antagonists in COS. We conducted Cochrane\u2010standard systematic reviews, utilized GRADE for evidence certainty assessment, and employed GRADE Evidence\u2010to\u2010Decision Framework to derive recommendations. We pre\u2010defined clinically important outcomes, and the common critical outcomes shared by all clinical questions as follows: live birth rate, implantation rate, clinical pregnancy rate, and moderate to severe ovarian hyperstimulation syndrome (OHSS). We strictly followed the RIGHT guideline and AGREE\u2010II criteria throughout the CPG development.<\/jats:p><jats:p><jats:bold>Recommendations:<\/jats:bold> The guideline development group (GDG) agreed on 14 recommendations on the application of GnRH\u2010ant during COS. In summary, low certainty of evidence supported the benefits of using GnRH\u2010ant protocol in IVF patients with high ovarian response (HOR), following with very low certainty of evidence to use Oral Contraceptive Pill (OCP) or estrogen as pretreatment in normal ovarian response (NOR) patients, low certainty of evidence to use fixed GnRH\u2010ant protocol and very low certainty of evidence to use GnRH agonist (GnRH\u2010a) add on trigger. For patients using GnRH\u2010ant protocol, very low certainty of evidence in HOR patients and low certainty of evidence in NOR patients supported the \u201cfreeze\u2010all\u201d strategy considering the potential risk associated with fresh embryo transfer. However, multiple fresh embryo transfer may still provide benefits in some cases.<\/jats:p>","DOI":"10.1002\/gin2.70022","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T06:30:09Z","timestamp":1747809009000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Recommendations for the management of GnRH\u2010ant for ovarian stimulation in the assistant reproductive process: Benefits and harms for different ovarian response population"],"prefix":"10.1002","volume":"2","author":[{"given":"Rong","family":"Li","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Center for Reproductive Medicine Peking University Third Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Center for Reproductive Medicine Peking University Third Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhao","family":"Yan","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health Shandong University Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Song","sequence":"additional","affiliation":[{"name":"Institute of Digestive Disease and Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Li Ka Shing Institute of Health Sciences, CUHK Shenzhen Research Institute The Chinese University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunxia","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology The First Affiliated Hospital of Anhui Medical University Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zijiang","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Reproductive Medicine and Offspring Health, Center for Reproductive Medicine, Institute of Women, Children and Reproductive Health Shandong University Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenchen","family":"Xu","sequence":"additional","affiliation":[{"name":"Tianjin Suyuan Evidence Based Technology Co., Ltd.  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