What is it?

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This topic contains 22 replies, has 21 voices, and was last updated by Apple Apple 1 year, 2 months ago.

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  • #94

    Leyla
    Participant

    I faced with the term of empty follicle syndrome. ..can you explain me what is this empty follicle syndrome….because i don’t know anything about it! :wacko:

    • This topic was modified 1 year, 10 months ago by  Leyla.
    #95

    Claudia
    Participant

    The empty follicle syndrome (EFS) is a frustrating condition in which no oocytes are retrieved in an IVF cycle. Although this is an infrequent event in IVF patients, the economic consequences as well as the emotional frustration of a cancelled cycle due to the inability to obtain oocytes are enormous.

    #98

    Eva
    Participant

    The mechanisms responsible for EFS remain obscure, though many hypotheses have been put forward ranging from dysfunctional folliculogenesis to a drug-related problem. We found that the EFS is a rare event (1.8% of oocyte retrievals) but with profound implications for counselling the couple about their future reproductive performance. The chances of recurrence of EFS increase with the age of the patient (24% recurrence rate for the 35–39 year age group, and 57% for those over 40 years). We postulate that ovarian ageing, through altered folliculogenesis, may be implicated in the aetiology of EFS and its recurrence.

    #99

    Mary
    Participant

    It has been more than a decade since the concept of empty follicle syndrome (EFS), in which no oocytes are retrieved in an IVF cycle, was introduced. EFS has been reported to occur in natural as well as stimulated cycles in which multiple follicles develop yet no oocytes are retrieved. The incidence of this syndrome in patients undergoing IVF has been estimated to be about 2–7% , although a more recent report suggests a lower incidence.

    #102

    Messy
    Participant

    The doctor starts puncturing the follicles, and is dismayed when the embryologist does not get any eggs whatsoever in the follicles. The procedure in the OR seems to be technically straightforward. The follicles collapse when aspirated and there is free flow of follicular fluid into the test tubes. However, when the embryologist scans the follicular fluid under his microscope, he does not find any eggs as all !

    #103

    gloria
    Participant

    This is unexpected and uncommon; and many doctors are completely stumped as to what to do when this happens, because they have not dealt with this condition earlier. This is actually a medical emergency, but is often managed badly. Because many doctors don’t know how to deal with this problem, they tend to just continue with the procedure blindly, and suck out the follicular fluid from all the follicles. After completing the procedure, they then leave the theater. When the embryologist then reports that he cannot find any eggs, they tell the patient – Sorry, we did not get any eggs at all.

    #142

    Camila
    Participant

    Empty follicle syndrome (EFS), although rare with an incidence of 0.2–7%, is a frustrating condition where no oocytes are retrieved in in vitro fertilization (IVF), even though ultrasound and estradiol measurements show the presence of many potential follicles. It is a complex phenomenon that cannot be explained by low bioavailability of human chorionic gonadotrophin alone; neither can it be reliably diagnosed by the measurement of serum beta-human chorionic gonadotrophin (bhCG) on the day of oocyte retrieval (OR), except possibly when the bhCG concentration is very low.

    #143

    Camila
    Participant

    It is evident from a review of literature that two types of EFS exist: genuine (GEFS) and false (FEFS). About 67% of all cases are due to human error, suggesting that GEFS is an even rarer event than previously presumed.

    #146
    Victoria
    Victoria
    Participant

    Empty follicle syndrome (EFS) has been defined as a condition in which no oocytes are retrieved from mature ovarian follicles with apparently normal follicular development and estradiol levels, after Controlled ovarian hyper stimulation (COH) for an assisted reproductive technology (ART) cycle, despite repeated aspiration and flushing.

    • This reply was modified 2 years, 2 months ago by Victoria Victoria.
    #242
    Alice
    Alice
    Participant

    “Empty follicle” syndrome is a description/name of a condition that is found when no eggs are retrieved from obviously adequate sized follicles. It can occur at any age, but seems to be more prevalent the older one gets. So, a woman in her 40’s could still have regular menstrual cycles and ovulation, but no egg will be ovulated so pregnancy does not occur. With IVF, we find this when we go to retrieve and get no eggs back. It is thought that this is the “normal natural condition” in the aging ovary. A woman essentially runs out of eggs. However, that does not seem to be the case in younger woman, since younger women stil have a full complement of eggs. So, “running out of eggs” does not seem to be the whole answer.There are many factors that can lead to no eggs. Of course one is the empty follicle syndrome, however, in my experience and that reported, it is sporadic and not something that is repetitive. So I’m a little surprised that it has happened to you so many times. Another cause is a lack of adequate stimulation by HCG, which causes the final egg maturation and release from the follicle wall. That may be the culprit in most cases. Another is triggering too early so that the egg doesn’t reach maturation and is not release. That’s a doctor timing problem, and the fact that you’ve had this several times makes me wonder about this possibility. Without reviewing your medical records, I can’t give you more specifics that this.

    #279
    Kate
    Kate
    Participant

    Egg retrieval is usually a very straightforward procedure and generally when there are a reasonable number of follicles seen on the ultrasound scan, we expect to collect eggs. However, sometimes, much to the team’s horror and the patient’s dismay, we do not get any eggs at all. Fortunately, this is not common, but it is devastating for those who experience it. Below is a little more about why this can happen.Technically, when there are no eggs collected at the egg collection procedure, this condition is called “Empty Follicle Syndrome” or EFS. EFS is a frustrating condition in which no oocytes (eggs) are retrieved at IVF, even though ultrasound and estradiol (female hormone measured in the blood) showed the presence of many potential follicles.

    #299

    Camila
    Participant

    Empty follicle syndrome (EFS) has been defined as a condition in which no oocytes are retrieved from mature ovarian follicles with apparently normal follicular development and estradiol levels, after COH for an assisted reproductive technology (ART) cycle, despite repeated aspiration and flushing.

    #305
    Milka
    Milka
    Participant

    Empty follicle syndrome is a condition in which no oocytes are retrieved after an apparently adequate ovarian response to stimulation and meticulous follicular aspiration. It is a rare condition of obscure etiology. A patient with primary infertility who underwent seven assisted reproductive technique cycles is described. In spite of a satisfactory ovarian response, aspiration yielded no oocytes in four cycles and 1-4 low quality oocytes in three cycles. In the index treatment cycle, ovulation was triggered using GnRH agonist 40 h prior to ovum pickup and hCG was added 6 h after the first trigger. Eighteen oocytes were recovered, of which 16 were mature and were inseminated by ICSI. Two embryos were transferred 48 h after aspiration and nine embryos were cryopreserved. The patient conceived and delivered a healthy boy at 38 weeks of gestation.

    #336
    Molly
    Molly
    Participant

    The empty follicle syndrome (EFS) is characterized by the lack of retrieved oocytes from follicles after ovulation induction and apparently normal follicular development for in vitro fertilization, despite repeated aspiration and flushing. The underlying mechanism of the EFS remains hypothetical. Some Authors have suggested that it is related to the “cause” leading to female infertility, whereas others have pointed to the alternative suggestion that it might reflect dysfunctional folliculogenesis, with early oocyte atresia and apparently normal hormonal response. Moreover, some Authors believe that the EFS does not exist, and that the oocyte retrieval failure is a pharmacological fault. The risk of recurrence is higher as the age of the patients increases. The EFS cannot be predicted by the pattern of ovarian response to stimulation either sonographically or hormonally. Consequently, the diagnosis of EFS is retrospective. Whatever the underlying cause of an EFS cycle, patients with an EFS cycle should be counselled regarding the possibility of recurrence of such an event in future cycles.

    #364

    Wilma
    Participant

    It has been already mentioned, that this syndrome is a problem with the lack of retrieved oocytes from follicles after ovulation induction. However, for me these words are still too hard. I know that I am ill and I know that there is a treatment process for this disease and it is quite long. To my mind you shouldn`t search for additional info about this problem as it is unhelpful. The only thing you can do is to stay near and let her talk about her problems. As in my situation, I am very shy to talk about it so there is no possibility for me to share this problem with anyone except my husband. But I know, that your friend needs someone to be near and to talk to her about it. Let her explain what it means. Good luck!

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