Empty follicle syndrome: Successful pregnancy following dual trigger

Krishna, Daida; Suvarna, R; Garg, Navneet; Rao, Kamini A

doi:10.4103/0974-1208.165152

Cited by 15 publications

(11 citation statements)

References 24 publications

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“…A similar case has been described by Deepika et al. ( 34 ), with two consecutive EFS cycles with adequate follicular development and hormonal levels, and an uneventful oocyte pick-up after the use of an hCG trigger. In a third attempt, using GnRH antagonist co-treatment, the dual trigger option was chosen.…”

Section: Empty Follicle Syndrome Following Hcg Triggersupporting

confidence: 69%

Gonadotropin-releasing hormone agonist ovulation trigger—beyond OHSS prevention

Castillo

Haahr

Martínez-Moya

et al. 2020

Upsala Journal of Medical Sciences

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In this review the advantages of the gonadotropin-releasing hormone agonist (GnRHa) trigger are discussed beyond those immediately associated with ovarian hyperstimulation syndrome (OHSS) prevention. The GnRHa trigger concept has sparked the development of novel protocols, enriching the assisted reproductive technology (ART) armamentarium for the benefit of present and future patients. Thus, GnRHa trigger already has a pivotal role, not only for the standard in vitro fertilisation (IVF) patient, but also for patient groups like oocyte donors, cancer patients, patients with poor ovarian reserve, and patients with immature oocyte syndrome and empty follicle syndrome. Herein, we discuss the importance of the GnRHa-elicited midcycle FSH surge and the potential improvement in oocyte yield and embryo competence.

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Section: Empty Follicle Syndrome Following Hcg Triggersupporting

confidence: 69%

Gonadotropin-releasing hormone agonist ovulation trigger—beyond OHSS prevention

Castillo

Haahr

Martínez-Moya

et al. 2020

Upsala Journal of Medical Sciences

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“…EFS can be classified as either "false" EFS or "genuine" EFS. The "false" EFS was due to the inappropriate timing and dosage of HCG administration (Isik & Vicdan, 2000;Meniru & Craft, 1997;Quintans, Donaldson, Blanco, & Pasqualini, 1998), after rescue protocols (Deepika, Rathore, Garg, & Rao, 2015;Hassan, Saleh, Khalil, Baghdady, & Ismaiel, 1998;Lok, Pritchard, & Lashen, 2003;Ndukwe et al, 1997;Penarrubia et al, 1999;Ubaldi et al, 1997), the oocytes can be harvested; whereas "genuine" EFS is termed as without oocytes nor cumulus-corona complexes being retrieved after improved protocols (La Sala et al, 1991;Onalan, Pabuccu, Onalan, Ceylaner, & Selam, 2003;Uygur, Alkan, & Batuoglu, 2003), which suggests underlying genetic defects. Previous studies identified homozygous mutations in the gene of LHCGR (MIM# 152790) in EFS (Yariz et al, 2011;Yuan et al, 2017).…”

mentioning

confidence: 99%

Compound heterozygousZP1mutations cause empty follicle syndrome in infertile sisters

et al. 2019

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Empty follicle syndrome (EFS) is a condition in which no oocyte is retrieved from mature follicles after proper ovarian stimulation in an in vitro fertilization procedure. Genetic evidence accumulates for the etiology of recurrent EFS without pharmacological or iatrogenic problems. In this study, we present two infertile sisters in a family with EFS after three cycles of standard ovarian stimulation with human chorionic gonadotrophin and/or gonadotropin‐releasing hormone agonist therapy. Via whole‐exome sequencing and cosegregation test, we identified compound heterozygous mutations in the gene of ZP1 in both of the infertile sisters. Coimmunoprecipitation tests and homology modeling analysis confirmed that both mutated ZP1 disrupt the formation of oocyte zona pellucida by interrupting the interaction among ZP1, ZP2, and ZP3. We thus propose that the specific mutations in ZP1 gene render a causality for the intractable EFS.

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“…The use of an antagonist protocol may release the growing follicles from the strong suppressive effect of a GnRH agonist. Additionally, dual triggering with HCG and GnRH agonist was used, as suggested in a previous case report (Deepika et al ., 2015). Furthermore, measuring HCG level on the day of ovum pick up confirmed our diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Repeated recovery of immature oocytes in a woman with a previous history of empty follicle syndrome

Al-Hussaini

Yosef

Elnashar

et al. 2019

JBRA Assisted Reproduction

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The empty follicle syndrome (EFS) is defined as a failure to aspirate any oocyte (s) from the follicles after ovarian hyperstimulation in preparation for IVF/ICSI. It is a frustrating and vague syndrome; and a controversial one concerning its existence, causes and possible treatment. Recurrent EFS or the recovery of immature oocytes thereafter is a more challenging problem. Delayed injection after leaving the immature oocytes for in vitro-maturation (IVM) has been suggested to be a possible option if immature oocytes are retrieved. Here, we present a case of repeated retrieval of a few immature oocytes after a first incidence of EFS. IVM was tried twice for those immature oocytes. Unfortunately, in this case IVM was unsuccessful and the oocytes failed to mature in vitro. Assistance is required for future management of these unfortunate couples.

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Empty follicle syndrome: Successful pregnancy following dual trigger

Cited by 15 publications

References 24 publications

Gonadotropin-releasing hormone agonist ovulation trigger—beyond OHSS prevention

Gonadotropin-releasing hormone agonist ovulation trigger—beyond OHSS prevention

Compound heterozygousZP1mutations cause empty follicle syndrome in infertile sisters

Repeated recovery of immature oocytes in a woman with a previous history of empty follicle syndrome

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