Recurrent empty follicle syndrome with different stimulation protocols - A case report

We report a case of recurrent empty follicle syndrome (EFS) where no oocytes were aspirated in two separate IVF cycles using two different protocols. In the second cycle, oocyte aspiration in one ovary was delayed for 24 hours after administering a second dose of human chorionic gonadotropin injection (hCG) and still no oocytes were recovered. In view of the presence of severe male factor infertility and failure to retrieve oocytes in 2 stimulated cycles, the couple was offered donor embryo transfer which resulted in a singleton pregnancy. A baby girl weighing 2800 g was delivered by an elective caesarean section at term. This case highlights that the change of protocol or repeat hCG administration is unlikely to change the outcome of genuine empty follicle syndrome.