It seemed plausible that prolonging the duration of the LH-surge with a second dose of kisspeptin-54 could induce OHSS in the high risk patient, as described in case-reports following GnRH-agonist triggering (Fatemi et al., 2014; Gurbuz et al., 2014; Ling et al., 2014). Here, GNRH1 is linked to ovarian hyperstimulation syndrome.