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Updated: Jun 22, 2026

Collection of Human Follicular Fluid, Follicle Somatic Cells, and Immature Oocytes from Individuals Undergoing In Vitro Fertilization
Published on: October 24, 2025
Empty follicle syndrome-Still an enigma
Deepika Krishna1, Lavanya Rajashekar, Madhuri Patil
1O.B.G-Infertility, Dr. Patil's Fertility and Endoscopy Clinic, No1, Uma Admiralty, 1 Floor, Banerghatta Road, Bangalore-560 029, Karnataka, India.
Abstract:
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. Here we report a case who underwent intracytoplasmic sperm injection (ICSI) for her partner's severe oligoasthenozoospermia. Controlled ovarian hyperstimulation (COH) was done in her first cycle of ICSI, using a gonadotrophin-releasing hormone (GnRH) agonist long protocol with follicle-stimulating hormone (FSH) and human menopausal gonadotrophin (HMG). However, as we were unable to retrieve any oocytes, her COH protocol was changed in the subsequent cycle with a successful outcome.
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