Empty follicle syndrome: the reality of a controversial syndrome, a systematic review

Stevenson, Tania Luisa; Lashen, Hany

doi:10.1016/j.fertnstert.2007.07.1312

Cited by 101 publications

(130 citation statements)

References 29 publications

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“…A systematic review reported that 67% of cases were so called false empty follicle syndrome mainly related to human error or pharmacological problems. 2 Two classes of EFS can be differentiated by hormone levels on the day of ovum pick up. In genuine EFS the level of either HCG, LH or progesterone are concordant with the correct administration of triggering drug while false EFS the levels are low.…”

Section: Discussionmentioning

confidence: 99%

“…When hcg was used as triggering agent different studies suggest that minimum serum β hcg concentration ranges from 5 to 161 IU/l. 2,5 In case of ovulation trigger with GnRH agonist, no cut off levels of LH or progesterone on the day of ovum pick up has been proposed. In contrast to hCG triggering, the action of GnRHa trigger is indirect via the endogenous release of LH and FSH from the pituitary.…”

Section: Discussionmentioning

confidence: 99%

“…1 Later it has been classified into ‛genuine' and ‛false' types by Stevenson and Lashen. 2 Genuine type has been defined as a failure to retrieve oocytes despite optimal hCG levels on the day of oocyte retrieval. Whereas false type has been defined as a failure to retrieve oocytes in the presence of low hCG due to an error in the administration or poor bioavailability of hCG.…”

Section: Introductionmentioning

confidence: 99%

“…Whereas false type has been defined as a failure to retrieve oocytes in the presence of low hCG due to an error in the administration or poor bioavailability of hCG. 2,3 The reported prevalence of EFS is 0.045-7% and is mostly FEFS. 4 When hCG was used as triggering agent different studies suggest that minimum serum β hCG concentration ranges from5 to 161 IU/l.…”

Section: Introductionmentioning

confidence: 99%

“…4 When hCG was used as triggering agent different studies suggest that minimum serum β hCG concentration ranges from5 to 161 IU/l. 2,5 Ovarian hyperstimulation syndrome (OHSS) is a potentially life threatening condition and is the most serious iatrogenic complication of controlled ovarian hyperstimulation cycles. 6 A single dose of GnRH agonist (GnRHa) for final oocyte maturation has been proposed as an effective strategy to prevent OHSS and as a first line protocol for treatment of oocyte donors.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Empty follicle syndrome after GnRH agonist trigger, rescued with HCG in a donor oocyte with successful pregnancy outcome: a case report

Mahapatro

Shankar

Varma

2016

Int J Reprod Contracept Obstet Gynecol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Empty follicle syndrome after GnRH agonist trigger, rescued with HCG in a donor oocyte with successful pregnancy outcome: a case report

Mahapatro

Shankar

Varma

2016

Int J Reprod Contracept Obstet Gynecol

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Empty follicle syndrome

Elnashar

2021

Assisted Reproduction Techniques

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A novel gene mutation in ZP3 loop region identified in patients with empty follicle syndrome

Zhang

Guo

et al. 2021

Human Mutation

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The zona pellucida (ZP) is an extracellular matrix surrounding mammalian oocytes. It is composed of three to four glycoproteins, ZP1–ZP4. ZP3 is essential for sperm binding and zona matrix formation. Here, we identified a novel heterozygous mutation (NM_001110354.2:c.502_504delGAG) of ZP3, occurring in a pair of sisters with empty follicle syndrome (EFS). A mouse model with the same mutation was established using the CRISPR/Cas9 gene‐editing system. As in the above family, F0‐, F1‐, and F2‐generation female mice with the mutation were all infertile. Further analysis using the Chinese hamster ovary cells (CHO‐K1) also showed that this mutation weakens the strength of binding between ZP3 and ZP2, which hinders the assembly of ZP and results in unstable ZP formation. Immunohistochemical analysis using ovarian serial sections in both humans and mice demonstrated that the ZP of preantral follicles was thinner than normal control, or even absent. Our study presents a new gene mutation that leads to EFS, providing new evidence and support for the genetic diagnosis of infertile individuals with similar phenotypes. Our results also show that the loop of ZP3 is not only a linker between two amphiphilic helices but may play a critical role in specifying the correct heterodimerization partner.

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Empty follicle syndrome: the reality of a controversial syndrome, a systematic review

Cited by 101 publications

References 29 publications

Empty follicle syndrome after GnRH agonist trigger, rescued with HCG in a donor oocyte with successful pregnancy outcome: a case report

Empty follicle syndrome after GnRH agonist trigger, rescued with HCG in a donor oocyte with successful pregnancy outcome: a case report

Empty follicle syndrome

A novel gene mutation in ZP3 loop region identified in patients with empty follicle syndrome

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