Failure to collect oocytes in assisted reproductive technology: a retrospective

Abstract

While there is much information and discussion on pregnancy failure after assisted reproductive technologies, less emphasis is placed on the failure to collect oocytes after apparently successful ovarian stimulation. This retrospective survey reviewed 4973 treatment cycles in order to obtain information about the likelihood of this event. Overall 42 women (43 treatment cycles) failed to have oocytes collected [0.86% of treatments started and 0.92% of women given human chorionic gonadotrophin (HCG)]. However, in only six cases was this failure unexpected (0.1%) with no obvious potential clinical reason (i.e. all six cases had: HCG administered; more than two follicles >15 mm in diameter; oestradiol values >2000 pmol/l; <38 years old; normal body mass index). Indifference concerning uncommon events is fraught with peril, as although rare, the particular outcome may be devastating to the individual, both economically and psychologically. Eighteen of the 42 women did not return for on-going treatment suggesting increased contact by clinic staff may be required when oocyte retrieval is not achieved. These data suggest that the failure to collect oocytes after apparently successful ovarian stimulation is rare and random. The information has proved useful in allaying the fears of couples contemplating assisted reproductive technologies.

Empty follicle syndrome

“…EFS is an uncommon event, estimated to occur in 0.045% to 7% of patients undergoing ovum pickup (OPU) [2-4,7-12]. This variability may primarily result from different inclusion criteria.…”

Empty follicle syndrome: Successful pregnancy following dual trigger

“…Empty follicle syndrome (EFS), a much debated enigmatic syndrome, is annoying and highly stressful causing considerable concern for both the clinician and the patient. [ 1 ] EFS is defined as a condition in which no oocytes are retrieved from mature ovarian follicles following ovulation induction in an in-vitro fertilization (IVF) cycle with apparently normal folliculogenesis and steroidogenesis despite meticulous follicular aspiration and flushing. It cannot be predicted by the pattern of ovarian response to stimulation, either sonographically or hormonally.…”

Empty follicle syndrome: successful treatment in a recurrent case and review of the literature

“…It is a condition in which no oocytes are retrieved after an apparently adequate ovarian response to stimulation and meticulous follicular aspiration. EFS in the presence of dominant follicles is an uncommon event, estimated to occur in 0.045-3.5% of patients undergoing ovum pickup (OPU) (Ben-Shlomo et al, 1991;Awonuga et al, 1998;Driscoll et al, 1998;Zreik et al, 2000;Aktas et al, 2005;Coskun et al, 2010;Mesen et al, 2011;Castillo et al, 2012).…”