Open AccessA borderline form of empty follicle syndrome treated with a double-trigger of gonadotropin-releasing hormone agonist and human chorionic gonadotropin
Author(s) -
Jing-Yan Song,
ZhenGao Sun
Publication year - 2019
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000016213
Subject(s) - human chorionic gonadotropin , medicine , ovulation , gonadotropin , in vitro fertilisation , ovulation induction , controlled ovarian hyperstimulation , context (archaeology) , follicular phase , endocrinology , oocyte , ovarian hyperstimulation syndrome , andrology , agonist , gonadotropin releasing hormone agonist , gonadotropin releasing hormone , hormone , luteinizing hormone , pregnancy , embryo , receptor , biology , paleontology , microbiology and biotechnology , genetics
Rationale: The borderline form of empty follicle syndrome (EFS) is a phenomenon where only a few mature or immature oocytes are retrieved despite adequate response to controlled ovarian hyperstimulation (COH). It is a rare phenomenon with an unclear underlying mechanism, and there is currently no effective treatment. Patient concerns: The patient received 3 assisted reproductive technology cycles, and although her follicular development and estrogen levels were normal during COH, the outcome with respect to the oocytes obtained was unsatisfactory. Diagnoses: Borderline form of EFS. Interventions: In the context of undergoing GnRH-antagonist protocol, we implemented a double-trigger with human chorionic gonadotropin (hCG) after 6 hours of gonadotropin-releasing hormone agonist (GnRH-a) administration. Outcomes: Eleven oocytes were obtained (M I × 3, M II × 8), which underwent in vitro fertilization (IVF). After 18 hours, 7 oocytes showed normal fertilization, with 2 embryos formed 72 hours later (embryo rating, 6C II × 1, 9C II × 1); the embryos were then frozen. Lessons: Oocyte maturation and ovulation are time-dependent processes, and that different patients require different lengths/intervals of time for treatment. Therefore, the borderline form of EFS, in general, may be treatable, and our novel trigger method provides a new treatment option for such patients in the future.