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Predicting empty follicle syndrome
G Ndukwe1, S Thornton, S Fishel
1Nottingham University Research and Treatment Unit in Reproduction (NURTURE), Department of Obstetrics and Gynaecology, Queen's Medical Centre, United Kingdom.
Objective:
To determine a simple predictive test for empty follicle syndrome before oocyte retrieval.
Design:
Retrospective correlation analysis.
Setting:
Patients attending Nottingham University Research and Treatment Unit, a tertiary, university-based assisted reproductive technologies (ART) program between April 1, 1994 and March 31, 1995.
Patient(S):
Six women in whom no oocytes were retrieved after superovulation for ART (empty follicle syndrome) were compared with 11 women with successful oocyte retrieval.
Intervention(S):
Subcutaneous buserelin acetate plus IM hMG and hCG were used for superovulation. Oocyte retrieval was transvaginal and ultrasound guided.
Main Outcome Measure(S):
Ultrasound measurement of follicular growth and serum E2 levels during superovulation. Serum beta-hCG levels before and 36 hours after hCG administration IM. Number of oocytes retrieved.
Result(S):
Before hCG administration, beta-hCG was not detectable in the serum. The serum beta-hCG 36 hours after hCG was 209 +/- 16.7 mIU/mL (conversion factor to SI units, 1.0; mean +/- SEM, range 106 to 290 mIU/mL) in women with successful oocyte retrieval and 4 +/- 1.8 mIU/mL (range 0 to 9 mIU/mL) in empty follicle syndrome. This difference was significant.
Conclusion(S):
Empty follicle syndrome is associated with very low bioavailability of beta-hCG and can be predicted by measuring serum beta-hCG level 36 hours after IM hCG administration.