Empty Follicle Syndrome EFS for 2 Cycles

samia812

Empty Follicle Syndrome EFS for 2 Cycles

Post by samia812 »

Hi,
I want to ask what is the best treatment for EFS . I know it is very uncommon but have you encountered cases like this before? my Dr and the IVF unit I go to haven't seen a case like mine. Everything in blood tests and ultrasounds is perfect till they do the retrieval an find no eggs.

I had 2 cycles of IVF , in both cycles the blood tests and Ultrasounds shows perfect follicles that matures very well, about 15-25 follicles . when I do the retrieval the follicles comes empty although I take the medications on time.
in 1st cycle I took Gonal F and Orgalutran and took Ovitrelle 250mcg 36 hours before operation and I had 2 eggs although the Dr expected +10
in 2nd Cycle , I took Menapur and Orgalutran and took Ovitrelle 250mcg 36 hours prior to operation and no eggs were found.

I started a new cycle today with menapur and probably Orgalutran . My Dr wants to give me Three 5000IU Pregnyl this time before retrieval, I think on a 2 days period and also wants to give me more time period to mature the follicles. He also wants me to take the shots in the muscle instead of of the belly.

can u please help me?
Dr. Wisot
Site Admin
Posts: 1208
Joined: Fri Oct 14, 2005 11:16 am

Re: Empty Follicle Syndrome EFS for 2 Cycles

Post by Dr. Wisot »

We have seen this problem.

In your case they used the synthetic LH (Ovidrel in the U.S.) twice and that may not work for you. So switching to Pregnyl (hCG) might help and in these cases I have given 20,000 units. Ovidrel is particularly dependent on weight so if you are overweight that could be part of the problem.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
samia812

Re: Empty Follicle Syndrome EFS for 2 Cycles

Post by samia812 »

Hi,
just wanted to update you that I had my egg retrieval yesterday , I used the same protocol Menapur , then I used orgaltutran and Pergoveris, and I took 10,000 units of pregnyl 38 hours before operation and another 5,000 units 22 hours before operation in the muscles. I got 12 eggs :D I'm waiting for them to call about the embryos :roll:

Thank you
samia812

Re: Empty Follicle Syndrome EFS for 2 Cycles

Post by samia812 »

hi,
they called and I had 7 good embryos :lol:
Dr. Wisot
Site Admin
Posts: 1208
Joined: Fri Oct 14, 2005 11:16 am

Re: Empty Follicle Syndrome EFS for 2 Cycles

Post by Dr. Wisot »

:D :D :D :D :D :D

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group, Inc.
Redondo Beach, California
Salma85

Re: Empty Follicle Syndrome EFS for 2 Cycles

Post by Salma85 »

Hi,

I am sad to say I have the same problem for two cycles...can I contact you samia812..
please Dr.Wisot read ny story and tell me about the best solutions for me:
I am 29 years old.... have PCOS...my weight is normal 64 kg (tall 169 cm)...Amh 7.95 ug/l
tried several cycles of clomid...one IUI always I had good response and had good follicles
the doctor adviced me to try stimulation using injections due to the thin lining uterus....

I tried two unsuccesful IVF due to empty follicles due to empty follicles

the first I used merional 0.75 and 2 tablets clomid daily ... I had 22 follicles sizes 19mm-20mm.... I get pregnyl shot before 36 hours of egg retireval.. I get only two immature (abnormal) eggs which cant be fertilized.....after that I suffered from hyperstimulation

the second I used puregon (50) with one tablet clomid daily....I have 9 good follicles 20mm... I took decapeptyl shot before 36 hours of the retireval... I get no eggs :(

I did the genetic test it was normal 46xx
I have vitamin d deficiency

my doctor suggest to try natural IVF cycle next month ( with no medications) do you think this is good choice for me?
what do you think the reason of this case... what is the best protocol for my case....
Is that possible that I dont have eggs in this age????

waiting you kind reply
thank you
Dr. Wisot
Site Admin
Posts: 1208
Joined: Fri Oct 14, 2005 11:16 am

Re: Empty Follicle Syndrome EFS for 2 Cycles

Post by Dr. Wisot »

At 29 with PCOS there should be eggs to retrieve.

As I stated in a message in response to the original question, I have been successful using a double dose of Pregnyl (hCG) of 20,000 units.

With "natural cycle IVF" it actually may be more difficult to get an egg because of the timing.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Salma85

Re: Empty Follicle Syndrome EFS for 2 Cycles

Post by Salma85 »

Thank you for your kind reply

I disscuced increasing HCG shot with my doctor >> he said that it may increase the risk of hyperstimulation.... since I suffered from hyperstimulation in my first IVF cycle with 5000 units of pregnyl.

what do you think !!
Dr. Wisot
Site Admin
Posts: 1208
Joined: Fri Oct 14, 2005 11:16 am

Re: Empty Follicle Syndrome EFS for 2 Cycles

Post by Dr. Wisot »

That would be a concern if you previously hyperstimulated which I did not know.

They could try a low stimulation with 20,000 hCG, regular stimulation with a Lupron trigger, or a minimal stimulation with just Clomid and the 20,000.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Salma85

Re: Empty Follicle Syndrome EFS for 2 Cycles

Post by Salma85 »

Thank you very much for your reply ,, I am really appreciate your cooperation

actually there are a lot of small cycts in my ovaries...I would like to ask you about surgical method called LOD " Laprscopic drilling Ovaries" DO you think doing this surgical operation can help me.. tell me about the side effects of this operation.. and for which women is recommended? Does this surgery affect my ovarian egg reserve?? and how many months I will feel better after this surgery?

Thank you very much
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