The prevalence of genuine empty follicle syndrome

Mesen, Tolga B.; Yu, Bo; Richter, Kevin S.; Widra, E.A.; DeCherney, Alan H.; Segars, James H.

doi:10.1016/j.fertnstert.2011.09.047

Cited by 45 publications

(34 citation statements)

References 31 publications

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“…Another important aspect of agonist-triggered cycles is the incidence of empty follicle syndrome (EFS). The incidence of EFS has been reported as 0.6%-3.5% in GnRHa trigger cycles, which is similar to that reported (0.1%-3.1%) after an hCG trigger (12,19,(25)(26)(27)(28)(29). Therefore, EFS is not an inherent and exclusive problem to the GnRHa trigger (25) but could be related to human error, abnormalities in the in vivo biological activity of some batches of commercially available GnRHa, hypothalamic dysfunction, or GnRH receptor mutations (23,26,(28)(29)(30).…”

Section: Discussionsupporting

confidence: 85%

Gonadotropin-releasing hormone agonist triggering is effective, even at a low dose, for final oocyte maturation in ART cycles: Case series

Gülekli¹,

Göde²,

Sertkaya³

et al. 2015

J Turkish German Gynecol Assoc

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Objective:To investigate the efficacy of low-dose gonadotropin-releasing hormone (GnRH) agonist for final oocyte maturation in females undergoing assisted reproductive treatment (ART) cycles. Material and Methods:Nine females undergoing ovarian stimulation in a GnRH antagonist protocol who received triptorelin 0.1 mg to trigger final oocyte maturation were included. Treatment outcomes of these patients were compared with those of controls, matched for age and oocyte number (n=14), who received 0.2 mg triptorelin at the same time. The luteal phase was supported with vaginal micronized progesterone and oral estradiol hemihydrate 2 mg twice daily. Results:The mean (±) numbers of retrieved, metaphase II, and fertilized oocytes were 15.66±7.82, 14±7.28, and 10.11±5.86, respectively.The implantation and clinical pregnancy rates were 46.1% and 71.4%, respectively. Of the pregnancies, 2 were live births, 1 was a preterm birth (twins), 2 are on-going, and 2 ended as miscarriages. No case of OHSS was encountered. On comparison of the results of these patients (fresh cycles; n=7) with those of matched controls, there were no significant differences in terms of retrieved mature oocytes, implantation rates, or clinical pregnancy rates (p>0.05). Conclusion:These findings suggest that low-dose GnRH agonist triggering has similar efficacy as standard doses in terms of retrieved mature oocytes and clinical pregnancy rates in in vitro fertilization cycles. (J Turk Ger Gynecol Assoc 2015; 16: 35-40) Keywords: Agonist trigger, triptorelin, oocyte maturation, oocyte retrieval, pregnancy rate Received: 21 June, 2014 Accepted: 05 December, 2014 Gonadotropin-releasing hormone agonist triggering is effective, even at a low dose, for final oocyte maturation in ART cycles: Case series AbstractOriginal Investigation

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Section: Discussionsupporting

confidence: 85%

Gonadotropin-releasing hormone agonist triggering is effective, even at a low dose, for final oocyte maturation in ART cycles: Case series

Gülekli¹,

Göde²,

Sertkaya³

et al. 2015

J Turkish German Gynecol Assoc

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“…[3][4][5][6][7] A retrospective study of 12,359 individuals who underwent assisted reproductive technology (ART) revealed that the prevalence of GEFS was about 0.016%. 8 Without oocytes for fertilization, these individuals fail to achieve pregnancy after a demanding and expensive medical intervention, resulting in stress to both physicians and the individuals themselves. 9 In this study, we identified a heterozygous missense mutation in ZP3 (MIM: 182889; GenBank: NM_001110354.1) from a large family with multiple women affected by EFS.…”

Section: Efs Can Be Classified As Either False Efs (Fefs) or Genuine mentioning

confidence: 99%

“…3-7 A retrospective study of 12,359 individuals who underwent assisted reproductive technology (ART) revealed that the prevalence of GEFS was about 0.016%. 8 Without oocytes for fertilization, these individuals fail to achieve pregnancy after a demanding and expensive medical intervention, resulting in stress to both physicians and the individuals themselves.9 …”

mentioning

confidence: 99%

A Recurrent Missense Mutation in ZP3 Causes Empty Follicle Syndrome and Female Infertility

Chen

Bian

Liu

et al. 2017

The American Journal of Human Genetics

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Empty follicle syndrome (EFS) is defined as the failure to aspirate oocytes from mature ovarian follicles during in vitro fertilization. Except for some cases caused by pharmacological or iatrogenic problems, the etiology of EFS remains enigmatic. In the present study, we describe a large family with a dominant inheritance pattern of female infertility characterized by recurrent EFS. Genome-wide linkage analyses and whole-exome sequencing revealed a paternally transmitted heterozygous missense mutation of c.400 G>A (p.Ala134Thr) in zona pellucida glycoprotein 3 (ZP3). The same mutation was identified in an unrelated EFS pedigree. Haplotype analysis revealed that the disease allele of these two families came from different origins. Furthermore, in a cohort of 21 cases of EFS, two were also found to have the ZP3 c.400 G>A mutation. Immunofluorescence and histological analysis indicated that the oocytes of the EFS female had degenerated and lacked the zona pellucida (ZP). ZP3 is a major component of the ZP filament. When mutant ZP3 was co-expressed with wild-type ZP3, the interaction between wild-type ZP3 and ZP2 was markedly decreased as a result of the binding of wild-type ZP3 and mutant ZP3, via dominant negative inhibition. As a result, the assembly of ZP was impeded and the communication between cumulus cells and the oocyte was prevented, resulting in oocyte degeneration. These results identified a genetic basis for EFS and oocyte degeneration and, moreover, might pave the way for genetic diagnosis of infertile females with this phenotype.During in vitro fertilization (IVF) treatment, oocyte retrieval is performed after ovarian stimulation via vaginal puncture. Cumulus-oocyte complexes (COCs), which consist of cumulus cells surrounding the centrally located oocyte, are isolated from the individual's follicular fluid. As was first described by Coulam et al. in 1986, empty follicle syndrome (EFS) is a condition in which the ovarian response to stimulation and follicular development seems normal but no oocytes are retrieved for fertilization.1 EFS can be classified as either false EFS (FEFS) or genuine EFS (GEFS). FEFS is mainly caused by pharmacological or iatrogenic problems; however, the etiology of GEFS, which is responsible for about 33% of EFS, still remains enigmatic. 2 It has been proposed that GEFS is caused by dysfunctional folliculogenesis, ovarian aging, or genetic factors including pericentric inversion of chromosome 2 and LHCGR (MIM: 152790) mutations. 3-7 A retrospective study of 12,359 individuals who underwent assisted reproductive technology (ART) revealed that the prevalence of GEFS was about 0.016%. 8 Without oocytes for fertilization, these individuals fail to achieve pregnancy after a demanding and expensive medical intervention, resulting in stress to both physicians and the individuals themselves.9

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“…[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. [19] Bizim ça-lışmamızda tüm final oosit maturasyonu rekombinant hCG ile yapıldı ve boş folikül sendromu oranımız %1.4 idi.…”

Section: Discussionunclassified

Our Reasons for Cancellation During Intracytoplasmic Sperm Injection Cycles

Özkan¹,

Ekinci²,

Timurkan³

et al. 2014

J Kartal TR

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ÖzetAmaç: Yardımcı üreme teknikleri (YÜT) ile tedaviye alınan çiftlerde tedavinin yarıda bırakılması nadir görülen bir durum değildir. Stimülasyonun yarıda bırakılması veya embriyo transferine gidilememesi birçok farklı nedene bağlı olabilir. Bu yazıda Tüp Bebek Ünitemizde iptale giden olgularımızın özelliklerini irdeledik. Gereç ve Yöntem:Hastanemiz Tüp Bebek Ünitesi'nde Mayıs 2010-Ekim 2012 tarihleri arasında tedaviye alınan 554 çiftin kontrollü overyan hiperstimülasyon-intrasitoplazmik sperm injeksiyonu (KOH-ICSI) tedavilerinin geriye dönük analizi yapıldı.

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The prevalence of genuine empty follicle syndrome

Cited by 45 publications

References 31 publications

Gonadotropin-releasing hormone agonist triggering is effective, even at a low dose, for final oocyte maturation in ART cycles: Case series

Gonadotropin-releasing hormone agonist triggering is effective, even at a low dose, for final oocyte maturation in ART cycles: Case series

A Recurrent Missense Mutation in ZP3 Causes Empty Follicle Syndrome and Female Infertility

Our Reasons for Cancellation During Intracytoplasmic Sperm Injection Cycles

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