Empty follicle syndrome

Abstract

Empty follicle syndrome (EFS) is a condition in which no oocytes are retrieved after an apparently adequate ovarian response to stimulation and meticulous follicular aspiration. EFS can be classified into 'genuine' and 'false' types according to hCG levels. It is a rare condition of obscure etiology. The existence of genuine EFS has been questioned and is still controversial. The limitation around EFS is that the definition of EFS is obscure. Management of patients with EFS is a challenge to physicians. No single treatment is known to be universally effective. However, patients should be adequately informed regarding the importance of correct hCG administration because improper hCG administration is a common and preventable cause of EFS. EFS is a syndrome that deserves additional study because such investigation could lead to a further understanding of ovarian biology and infertility.

Our Reasons for Cancellation During Intracytoplasmic Sperm Injection Cycles

“…[16,17] Yanlış hCG uygulaması ve hCG farmakolojik özel-liklerinde bozulma şeklinde açıklanabilir etiyolojisi olduğu gibi hiçbir sebebin bulunamadığı durumlar da olmaktadır. [18] Gonadotropin salgılatıcı hormon (GnRH) antagonisti sikluslarında endojen LH salınımı için GnRH agonisti kullanıldığında boş folikül sendromuyla karşı-laşma oranı %1.4 oranında bildirilmektedir.…”

Clinical issues during ART

“…23 False EFS is more common compared to genuine EFS (0.072% and 0.016%, respectively). In genuine EFS, hCH level on the day of egg retrieval is >40 IU/L, whereas, in false EFS, hCH level is <40 IU/L, either because the patient did not administer the trigger hCG correctly, because the patient administered a faulty batch of hCG, or because of issues with the bioavailability of hCG.…”

Infertility and Immunocontraception based on zona pellucida

“…The occurrence of ''genuine'' empty follicle syndrome (GEFS) is often experienced in reproductive medicine. GEFS is usually considered to be derived from inadequate stimulation of gonadotropin or oocyte aspiration errors [47,48]. However, anti-ZP autoantibodies can induce GEFS.…”