Well, the right answer to your question probably does not exist. Many theories have been published on empty follicle syndrome. In the mentioned case, it may have been just casualty. Insufficient dose should be raised as an explanation, considering an individual need, but no one would know this before proceeding the first treatment cycle. Some would try to use a different hCG (urinary in case of a previous recombinant, or vice-versa) as an option in a future cycle, but, again, this is not preventable and it does guarantee a better response. Anyway, congratulations about the positive test. I hope this answer to help you in a future patient. Best wishes.

Many thanks for the answer and the wishes as well

Firas

Some patients may have less than optimal response on the antagonist protocol.

It is very satisfying she has conceived. In a non conceptive cycle one may consider changing the protocol to another type of GnRG analogue to verify the " emty follicles" are not related to the type of COH.

Thanks Mr.Zeev for the answer

There are many possible reasons. Besides the inadequate use of HCG, which is the most common reason for the Empty Follicle Syndrome, the use of HMG/LH may also play a role. With insufficient HMG/LH, the egg will stick on the wall of the follicle, thus hard to retrieve.

Thanks Yu for answer!

Despite I'm fully aware of all causes of empty follicle syndrome, i have reduced the hMG dose in the last 2 days of stimulation!! i think this is the most possible explanation for that.

Clinics sometimes are using max FSH levels for poor responders (specilally recombinant) instead of optimal or less dose..and they are getting some empty follicles..this is triggering oocyte lost ..this is my experience.

Thanks Bahar for the answer