完全取不到卵(Empty follicle syndrome, EFS)機率約2.3%   3/4發生於GnRHantagonist的COH療程
大部分EFS病患的卵巢並無明顯衰退 其原因可能在於卵長對於COH之藥物反應異常

J Hum Reprod Sci. 2018 Jul-Sep;11(3):274-278. doi: 10.4103/jhrs.JHRS_61_17.

Empty Follicle Syndrome: A Challenge to Physician.

Singh N1, Dalal V1, Kriplani A1, Malhotra N1, Mahey R1, Perumal V1.

Author information

Abstract

BACKGROUND:

Empty follicle syndrome (EFS) is a condition in which no oocytes are retrieved from normally growing ovarian follicles after ovarian stimulation. It is a rare and frustrating condition of obscure etiology.

OBJECTIVE:

The objective of this study was to estimate the incidence of EFS and study factors related to it.

DESIGN:

This was a retrospective study.

SETTING:

This study was conducted in hospital-based research center.

METHODS:

In 1968 in vitro fertilization cycles from January 2010 to August 2016 were studied. Agonist, antagonist, and miniflare protocols were used for the stimulation.

RESULTS:

The incidence of EFS is 2.38% (47/1968 cycles). Antagonist protocol group (76.59%, n = 36) had highest incidence of EFS (6.69%). Literature on EFS depicts decreased ovarian reserve (DOR) as the main cause, but only 4.25% of patients had DOR in our study. Interestingly, polycystic ovary syndrome and unexplained infertility were found in 31.9% of the cases. Serum anti-Müllerian hormone (AMH) levels (mean ± standard deviation [SD]) were 4.47 ± 3.54 ng/ml, and antral follicle count (AFC) was 15.30 ± 8.07 (mean ± SD) emphasizing that diminished ovarian reserve is not the main factor for EFS. All patients (n = 95) who underwent ovum pickup on day when any patient had EFS were taken as control. Patients with EFS were compared with controls. A statistically significant difference was not observed in serum AMH (P = 0.38) and AFC (P = 0.52).

CONCLUSION:

EFS is an uncommon event. Antagonist cycles have higher chances of empty follicle at ovum pickup. Looking at the profile of patients in this study, we conclude that EFS is not a manifestation of DOR.