Empty Follicle Syndrome EFS for 2 Cycles

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This topic contains 10 replies, has 11 voices, and was last updated by Apple Apple 1 year, 2 months ago.

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  • #157
    Victoria
    Victoria
    Participant

    A woman had 2 cycles of IVF , in both cycles the blood tests and Ultrasounds shows perfect follicles that matures very well, about 15-25 follicles . when she do the retrieval the follicles comes empty although she takes the medications on time.
    in 1st cycle shw took Gonal F and Orgalutran and took Ovitrelle 250mcg 36 hours before operation and she had 2 eggs although the Dr expected +10, no eggs were found.

    She started a new cycle today with menapur and probably Orgalutran . Her Dr wants to give her Three 5000IU Pregnyl this time before retrieval, she thinks on a 2 days period and he also wants to give me more time period to mature the follicles. He also wants me to take the shots in the muscle instead of of the belly.Ladies she is very afraid and no one can calm her nerves. What can you suggest?

    #250
    Alice
    Alice
    Participant

    EFS cases and their future cycles were reviewed. Clinical pregnancy rate per started cycle was taken as the primary outcome in assessing the future outcome in IVF treatment cycles.A total of 3023 patients underwent 5238 IVF treatment cycles. Twenty-six patients (1%) had a total of 58 (1%) cycles of EFS. Thirteen women went through 32 further IVF treatment cycles following the diagnosis of EFS, yielding only two clinical pregnancies, giving a clinical pregnancy rate of 6.25% per started cycle. In addition, four patients had recurrence in a total of 15 cycles.
    The occurrence of EFS will indicate poor IVF success in subsequent IVF cycles. Patients with “genuine EFS” should be counselled about the outcome of their future IVF cycles.

    #291
    Kate
    Kate
    Participant

    I am 29 years old…. have PCOS…my weight is normal 64 kg (tall 169 cm)…Amh 7.95 ug/ltried several cycles of clomid…one IUI always I had good response and had good follicles the doctor adviced me to try stimulation using injections due to the thin lining uterus….I tried two unsuccesful IVF due to empty follicles due to empty follicles the first I used merional 0.75 and 2 tablets clomid daily … I had 22 follicles sizes 19mm-20mm…. I get pregnyl shot before 36 hours of egg retireval.. I get only two immature (abnormal) eggs which cant be fertilized…..after that I suffered from hyperstimulation the second I used puregon (50) with one tablet clomid daily….I have 9 good follicles 20mm… I took decapeptyl shot before 36 hours of the retireval… I get no eggs :(I did the genetic test it was normal 46xx
    I have vitamin d deficiency. my doctor suggest to try natural IVF cycle next month ( with no medications).

    #318
    Milka
    Milka
    Participant

    It is not uncommon to hear women report that their IVF-egg retrieval yielded far fewer eggs than was expected and that when asking for an explanation they were told by their doctor that many of their follicles were “empty” and contained no eggs. This is at best an oversimplification of a complex situation, or at worst a flagrant misstatement; all follicles by definition must contain eggs.True, it is not unusual or irregular for egg retrieval to yield a few less eggs than the number of follicles would suggest. However, when less than 50% of follicles >15mm fail to yield eggs, something is wrong. Yet the circumstances surrounding failure of numerous follicles to yield the eggs they contain at the time of egg retrieval only serves to underscore the need to individualize COH protocols and to time the administration of the “hCG trigger”, precisely.

    #345
    Molly
    Molly
    Participant

    If an EFS cycle does occur during your treatment, please make sure you discuss it thoroughly with your fertility specialist, nurse and the clinic counsellor. EFS is an infrequent event and has been estimated to occur in between 2 – 7% of IVF cycles. However, the overall risk of recurrence in later IVF cycles is 20% and the risk of recurrence is higher as the age of the patient increases, with a risk of recurrence of <10% in patients <35 years, 24% for those between 35 and 39 years, and 57% for those over 40 years of age.The mechanism responsible for EFS remains obscure. Many hypotheses have been put forward, but none truly explain this syndrome. The most likely cause of EFS is ovarian aging, as many patients who suffer from EFS are also reduced responders. It is also possible that a patient may experience EFS if the trigger injection is mistimed. The egg collection procedure is usually scheduled for 36 hours after the trigger injection is administered. Much later than this can result in the eggs being ovulated from the ovary before the doctor has been able to perform the procedure.

    #407
    Monica
    Monica
    Participant

    Empty follicle syndrome (EFS) is characterized by a lack of retrieved oocytes in the presence of multiple follicle development, in both natural and stimulated cycles. The aim of the present case report is to point out the possibility of genetic factors that could be responsible for some occurrences of EFS. Two sisters with moderate deafness underwent controlled ovarian hyperstimulation and IVF/ICSI cycles at the same centre. During all three cycles there were normal follicular development, estradiol levels and bio‐available hCG plasma levels, but no oocytes and cumulus–corona complexes were retrieved, despite second hCG injections. These cases may represent an inherited condition of EFS with hearing loss with genetic factors affecting both the aetiology of EFS and the hearing loss.

    #492
    Bridget
    Bridget
    Participant

    To date, empty follicle syndrome (EFS) has only been reported in GnRH agonist down‐regulated IVF cycles. Some cases have been successfully treated by changing the batch, or by repeating the dose of hCG. A case of EFS was observed in both GnRH antagonist and GnRH agonist down‐regulated IVF cycles when final oocyte maturation was triggered using urinary hCG (u‐hCG). Failure to retrieve oocytes occurred, despite administration of a further dose of u‐hCG from a different batch and a delayed repeated oocyte recovery performed in the second GnRH agonist down‐regulated cycle. A successful oocyte recovery cycle was achieved after triggering of an endogenous gonadotrophin surge using GnRH agonist in an antagonist down‐regulated cycle. Nine oocytes were readily retrieved from 10 follicles, at 36 h after GnRH agonist administration, and eight of these fertilized normally. Two good quality embryos were used for fresh transfer and four were cryopreserved for future use. EFS can occur in GnRH antagonist down‐regulated IVF cycles, and can be successfully treated by triggering a natural gonadotrophin surge using GnRH agonist in the absence of any response to previous treatment methods. This represents a novel therapeutic modality for this uncommon but frustrating condition.

    #660

    Daria
    Participant

    According to medical statistics, a woman after 33 years of cycles without ovulation ( “cycles with no cell”) will be repeated more often than the 20-year-olds, ie 3-4 times a year. This is due to the coming changes in the female body: a decrease in sex hormones and the ability to grow high-grade cells. Is designed so that to give the command “start the growth of eggs,” the body receives from the higher centers of the head, but taking into account the views of the lower classes: ovarian, and other hormone foci (including adrenal glands and fat tissue). Therefore, the concomitant problems: obesity, polycystic, endometriosis, adhesions increases the probability of the formation of cysts.

    #698
    Ana
    Ana
    Participant

    i know what it is like when you worry lot about everything and i think that i may give you several pieces of advice. i think that it is very important to be healthy not only physically but also morally. i remember myself when i knew about it and i did not know what to do. i think that it is natural that you have stress and to my mind you just can not avoid it, because it is really very difficult to accept it and you are really very tired. but i think that there are a lot of ways to get rid of this stress and to my mind you just have to want to get rid of it and everything would be alright.spending a lot of time with people who also have some problem and who understand you very good is really good. i think that it may inspire you and give you a kick.

    #757

    Donna
    Participant

    The day after the puncture of the ovaries a woman starts treatment that preserves the pregnancy. To do this, the vagina is introduced special gel or capsule.
    Two weeks after the embryo transfer the woman makes pregnancy test from urine, the results of which it must necessarily notify your doctor. In the case of a positive result progesterone treatment is continued until 2-3-th month of pregnancy. Using ultrasound pregnancy can be seen already at day 28 after transplantation, when the ovum diameter is 10 mm.
    Viable embryos remaining after the transplant, the patient’s consent can be frozen and stored for 7 years. During this period, if you want them can be used for a new transplant.

    #834
    Apple
    Apple
    Participant

    I know that empty follicle syndrome is characterized by a lack of retrieved oocytes in the presence of multiple follicle development, in both natural and stimulated cycles.
    The aim of the present case report is to point out the possibility of genetic factors that could be responsible for some occurrences of EFS. Two sisters with moderate deafness underwent controlled ovarian hyperstimulation and IVF/ICSI cycles at the same centre. During all three cycles there were normal follicular development, estradiol levels and bio‐available hCG plasma levels, but no oocytes and cumulus–corona complexes were retrieved, despite second hCG injections.

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