In conventional controlled ovarian hyperstimulation (COH), final follicular maturation is usually triggered by a single bolus dose of human chorionic gonadotropin. For more than two decades, COH using multiple-dose GnRH antagonist with GnRH agonist (GnRHa) trigger has been used in attempts to eliminate severe early ovarian hyperstimulation syndrome (OHSS) and to improve oocyte/embryo yield and quality. Recently, GnRHa, combined with a human chorionic gonadotropin trigger, has also been implemented into clinical practice. Here, we present and discuss the hitherto published studies relating to various ways of triggering final follicular maturation, aiming to elucidate the appropriateness of each approach for specific patient subgroup needs.