Continuing the debate on empty follicle syndrome:: can it be associated with normal bioavailability of β-human chorionic gonadotrophin on the day of oocyte recovery?
Continuing the debate on empty follicle syndrome:: can it be associated with normal bioavailability of β-human chorionic gonadotrophin on the day of oocyte recovery?
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DOI：
10.1093/humrep/13.5.1281
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发表时间：
1998-05-01
影响因子：
6.1
通讯作者：
Schnauffer, K
中科院分区：
文献类型：
--
作者：
Awonuga, A;Govindbhai, J;Schnauffer, K
本文介绍了4个卵巢刺激性体外受精(IVF)周期的经验，在这些周期中，尽管人绒毛膜促性腺激素(β-HCG)在给药后35h在患者血液中的生物利用度正常，但仍未能取回卵母细胞。在3例患者中，卵母细胞回收过程中断，第二次注射HCG，并在24小时后收集其中2例患者的成熟卵母细胞。在第一例中，三个卵胞浆内单精子注射(ICSI)后受精的中期II期卵母细胞和两个卵裂的三级胚胎被移植，但没有妊娠。在第二例中，8个中期II卵母细胞中有6个在ICSI后受精和卵裂，导致1个2级胚胎和2个3级胚胎移植。这导致了一次临床怀孕，而在本报告所述时间段，这一情况仍在继续。第三例患者在之前的治疗周期中患有空卵泡综合征(EFS)，但仅吸入了卵丘-冠状复合体，采用了类似的抢救方案。另外5名在开始妊娠诊断试验筛查之前接受了EFS的患者有进一步的治疗周期，在这些周期中收集了卵母细胞，但没有随后怀孕。我们的结论是，在卵母细胞恢复当天，β-HCG的正常生物利用度并不排除EFS的诊断，EFS不能预测未来周期的生育潜力降低，尽管它可能是由于可获取的成熟卵母细胞的生物学异常而复发。在这类患者中，捐献卵子可能会提供怀孕的机会。
This paper describes our experience with four ovarian stimulation in-vitro fertilization (IVF) cycles in which we failed to retrieve oocytes despite normal bioavailability of beta-human chorionic gonadotrophin (beta-HCG) in patients' blood 35 h after HCG administration. In three cases, the oocyte recovery procedure was interrupted, a second dose of HCG was administered and 24 h later mature oocytes were collected from two of the patients. In the first case, the three metaphase II oocytes collected fertilized after intracytoplasmic sperm injection (ICSI) and two cleaved grade three embryos were transferred but pregnancy did not ensue. In the second case, six out of eight metaphase II oocytes fertilized and cleaved following ICSI, leading to transfer of one grade two and two grade three embryos. This resulted in a clinical pregnancy which at the time of this report is ongoing. A similar rescue protocol was used for the third case who had empty follicle syndrome (EFS) in her previous treatment cycle but only cumulus-corona complexes were aspirated. Five additional patients who had EFS before instituting pregnancy diagnostic test screening have had further treatment cycles in which-oocytes were collected but pregnancy did not ensue. We conclude that normal bioavailability of beta-HCG on the day of oocyte recovery does not exclude the diagnosis of EFS, EFS does not predict a reduced fertility potential in future cycles, although it may recur due to a biological abnormality in the availability of mature oocytes that are retrievable. In such patients, oocyte donation may offer the chance of achieving a pregnancy.