32 years old, first IVF cycle, normal ovarian reserve pt' BMI is 23 and was given 10000 IU hCG,, all eggs fertilized , 2 ET, pregnancy test positive.
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.
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 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.
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