We report a novel method of rescuing empty follicle syndrome (EFS) and
provide evidence that it is a drug-related problem rather than a clin
ical dysfunction, In a preliminary study we established that in EFS th
e serum beta-human chorionic gonadotrophin (beta-HCG) concentrations 3
6 h after HCG administration never exceeded 10 mIU/ ml, beta-HCG conce
ntrations were thus used to confirm EFS when oocytes mere not retrieve
d from one ovary after controlled ovarian hyperstimulation, The proced
ure was suspended leaving intact all follicles in the second ovary. Af
ter confirmation of EFS, a second HCG from a different batch was admin
istered and 36 h later mature oocytes were retrieved from the intact o
vary, suggesting a fault with the HCG previously administered. Three p
atients have been treated in this way, In the first case, four out of
five mature eggs were fertilized after intracytoplasmic sperm injectio
n (ICSI) resulting in the transfer of three top grade (grade 1) embryo
s, In the second case all seven mature oocytes fertilized after in-vit
ro fertilization (IVF) and three grade 1 embryos were transferred resu
lting in a twin pregnancy, now delivered, In the third case, five out
of nine oocytes were fertilized after ICSI and one out of the three tr
eated with high insemination concentration IVF fertilized, resulting i
n the transfer of three ICSI embryos.