The need for effectively inhibiting premature LH surge, during FSH administration for multifollicular development in in vitro fertilization (IVF), led to the use of GnRH analogues. Despite their disadvantages, including an increased risk of ovarian hyperstimulation syndrome (OHSS) and a prolonged administration required to achieve hypophysis downregulation, GnRH agonists served this purpose for many years, as the only available analogue. However, they were eventually replaced by GnRH antagonists, which, compared to GnRH agonists, vastly improved safety while maintaining efficacy and ensuring treatment simplicity. The use of GnRH antagonists in combination with cryopreservation of all embryos produced, led to the elimination of OHSS and introduced the concept of a freeze-all strategy as an alternative to fresh embryo transfer. If freeze-all is the strategy to be preferred, it is likely that control of premature LH surge can be further simplified by the use of oral progestins. On the other hand, if fresh transfer is the strategy to be preferred, then the development of oral GnRH antagonists is the next step for which data from relevant trials are eagerly awaited.