Empty follicle syndrome due to human errors: its occurrence in an in-vitro fertilization programme

We report five cases in which no oocytes were retrieved afterstandard ovarian stimulation for in-vitro fertilization (IVF),and in which it was found that mistakes had been made at thetime of human chorionic gonadotrophin (HCG) administration.In all five cases, oocyte retrieval was achieved after injectingHCG, when necessary, and reprogramming aspiration 24–36h later. A mean of 7 ± 3.2 MII oocytes were recoveredper patient and 3.2 ± 0.8 embryos were transferred. Threeclinical pregnancies were obtained, and four healthy infantswere born. In our programme, these were the only cases of emptyfollicle syndrome (EFS) that appeared over a total of 1118 cycles,and were all explained by human error in the administrationof HCG. Our experience shows that human error could be considereda significant factor in the aetiology of empty follicle syndrome,and that EFS may be in part avoided by taking simple preventivemeasures.