Oocytes in the empty follicle: a controversial syndrome
Oocytes in the empty follicle: a controversial syndrome
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DOI：
10.1016/j.fertnstert.2005.05.060
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发表时间：
2005-12-01
影响因子：
6.7
通讯作者：
de Jong, D
中科院分区：
文献类型：
--
作者：
Aktas, M;Beckers, NG;de Jong, D
目的：评估空卵泡综合征 (EFS) 的患病率和病因。设计：纵向观察研究。地点：三级生育中心。患者：包括 2002 年 12 月至 2004 年 11 月开始体外受精 (IVF) 治疗的所有患者。使用供体卵母细胞进行 IVF 或参与实验性 IVF 研究的夫妇被排除在分析之外。干预措施：识别 EFS 周期。比较 EFS 周期与正常 IVF 周期的卵巢过度刺激策略、卵泡计数和人绒毛膜促性腺激素 (hCG) 最终卵母细胞成熟的时间。主要结果指标：穿刺的卵泡数量、恢复的卵母细胞数量、之前和未来的 IVF 尝试以及血清激素水平。结果：总共 1,849 名患者中，有 25 名患者被确定为 EFS 周期。 EFS 周期发生的原因是 hCG 对最终卵母细胞成熟的时机错误、排卵过早和卵巢反应不佳。受影响的患者均未在早期 IVF 尝试中经历过 EFS 周期，也没有在后续治疗中出现任何复发。结论：准确诱导最终卵母细胞成熟的时机、正确安排卵巢过度刺激、患者和医生的指导以及 IVF 的全面检查对于卵母细胞的成功恢复至关重要。 IVF 中 EFS 的发生通常可归因于至少其中一个因素的失败，否则可能很少或从未发生。
Objective: To assess the prevalence and etiology of the empty follicle syndrome (EFS).Design: Observational longitudinal study.Setting: Tertiary fertility centers.Patient(s): All patients beginning in vitro fertilization (IVF) treatment from December 2002 to November 2004 were included. Couples undergoing IVF with donor oocytes or participating in an experimental IVF study were excluded from analysis.Intervention(s): Identification of EFS cycles. Comparing ovarian hyperstimulation strategy, follicle count, and timing of human chorionic gonadotropin (hCG) for final oocyte maturation of the EFS cycles with normal IVF cycles.Main Outcome Measure(s): Number of follicles punctured, number of oocytes recovered, previous and future IVF attempts, and serum hormone levels.Result(s): Twenty-five of a total of 1,849 patients were identified with an EFS cycle. Reasons for occurrence of EFS cycles were mistiming of hCG for final oocyte maturation, premature ovulation, and poor ovarian response. None of the affected patients had experienced EFS cycles in earlier IVF attempts nor were there any recurrence in subsequent treatments.Conclusion(s): Accurate timing of induction of final oocyte maturation, properly scheduled ovarian hyperstimulation, instruction of patients and doctors, and full workup for IVF are essential for the successful recovery of oocytes. Occurrence of EFS in IVF can normally be attributed to a failure of at least one of these factors and probably rarely or never occurs otherwise.