Empty follicle syndrome: evidence for recurrence

The empty follicle syndrome (EFS) is a frustrating condition in which no oo cytes are retrieved in an IVF cycle. Although this is an infrequent event i n IVF patients, the economic consequences as well as the emotional frustrat ion of a cancelled cycle due to the inability to obtain oocytes are enormou s. The mechanisms responsible far EFS remain obscure, though many hypothese s have been put forward ranging from dysfunctional folliculogenesis to a dr ug-related problem. We found that the EFS is a rare event (1.8% of oocyte r etrievals) but with profound implications for counselling the couple about their future reproductive performance. The chances of recurrence of EFS inc rease with the age of the patient (24% recurrence rate for the 35-39 year a ge group, and 57% for those over 40 years). We postulate that ovarian agein g, through altered folliculogenesis, may be implicated in the aetiology of EFS and its recurrence.