The exact causes and pathogenesis of empty follicles syndrome (EFS) still remains under-explored. Today, there are only a number of proven hypothesizes towards this abnormality. However, in reality it can be much more reasons for the EFS development. Ovarian aging is the most likely cause of EFS.

Depending on type of EFS the right cause of the disease can be determined.


There are false EFS which may be caused by incorrect level of hCG and genuine EFS when the woman had never experienced process of egg maturation.

Possible causes of false EFS:

  • Incorrect timing of CG injection (chorionic gonadotropic hormone) for stimulation of ovulation. Thus, this hormone must be given by injection in the space of 34-36 hours before IVF procedure. In such case eggs will have enough time for maturation;
  • Use of poor-quality medicine – expired medication or its incorrect storage;
  • Overripe follicles. It can be when the CG was given late or the dose was exceeded.

Possible causes of genuine EFS:

  • The Turner syndrome. It`s congenital condition when the ovules don’t develop at all in follicles. The percentage of this disease isn`t high;
  • Follicle dysfunction. When the follicles have abnormal formation that causes eggs’ aging or they don’t develop properly;
  • Unknown genetic causes.

Empty follicles syndrome is a rare disease among young women. This syndrome is most common for middle-age and older women. Only the doctor who performs IVF procedure can determine whether there is oocyte in the follicle by paracentesis of ovary.