What is an empty follicle?
Empty Follicle Syndrome is the condition in which no egg (oocyte) can be obtained from any follicle despite the egg collection process for in vitro fertilization (IVF) despite a positive response to ovarian stimulation for ovulation in IVF treatment. This condition is not very common in IVF treatments. This disorder can occur in 0.5-2% of women receiving treatment.
What causes it?
The cause of this disorder (etiology) has not yet been fully explained. The possible causes of empty follicle syndrome need to be well understood. There may be various reasons for this condition. Empty follicle syndrome occurs when the timing of the application of the human chorionic gonadotropin ( hCG ) hormone, which triggers oocyte maturation and facilitates the separation of the oocyte from the follicle, is not well planned. On the other hand, empty follicle syndrome may occur if the hCG preparation used is low in effectiveness (reduced biological activity). For this reason, the hCG preparation to be applied must be stored under good conditions, and the application time and dose must be well adjusted.
The level of hCG in the blood should be above 50 IU/L 12 hours after the injection. A level of hCG below this level is considered insufficient. In such cases, the application dose, timing of application and storage conditions of the preparation should be reviewed. 36 hours after the hCG injection (at the time of OPU), the level of hCG in the blood should be between 100 and 300 IU/L.
If empty follicle syndrome is encountered despite the normal hCG level in the blood at the time of oocyte retrieval (OPU), the inadequacy of the bioactivity of the hCG used should be considered.
If no eggs are obtained from one ovary at the time of egg collection, the other ovary should not be used and the hCG hormone level in the urine should be checked. If the hCG level in the urine is lower than it should be, the patient should be given another hCG injection and the other ovary should be subjected to egg collection after 36 hours. However, if the hCG level in the urine is normal, there is no need for another hCG injection.
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