Ovulation by repeated human chorionic gonadotrophin in 'empty follicle syndrome' yields a twin clinical pregnancy

This case illustrates the possibility of obtaining oocytes that fertilize and cleave normally after the administration of a second ovulatory dose of human chorionic gonadotrophin (HCG) in a case of 'empty follicle syndrome'. The present patient underwent ovarian stimulation with gonadotrophin-releasing hormone analogue (GnRHa)/menotropin for intracytoplasmic sperm injection (ICSI). After the failure of the first oocyte retrieval, a second dose of HCG was administered to trigger ovulation. A total of 13 oocytes was retrieved during the second procedure and 11 good quality embryos were obtained (fertilization and cleavage rates of 92 and 91% respectively). No pregnancy was achieved after the replacement of three embryos. In a subsequent cycle stimulated with clomiphene citrate, three frozen-thawed embryos were replaced and a twin pregnancy was achieved. The patient delivered two healthy babies at term.