Empty follicle syndrome: evidence for recurrence

The empty follicle syndrome (EFS) is a frustrating conditionin which no oocytes are retrieved in an IVF cycle. Althoughthis is an infrequent event in IVF patients, the economic consequencesas well as the emotional frustration of a cancelled cycle dueto the inability to obtain oocytes are enormous. The mechanismsresponsible for EFS remain obscure, though many hypotheses havebeen put forward ranging from dysfunctional folliculogenesisto a drug-related problem. We found that the EFS is a rare event(1.8% of oocyte retrievals) but with profound implications forcounselling the couple about their future reproductive performance.The chances of recurrence of EFS increase with the age of thepatient (24% recurrence rate for the 35–39 year age group,and 57% for those over 40 years). We postulate that ovarianageing, through altered folliculogenesis, may be implicatedin the aetiology of EFS and its recurrence.