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Friday, April 19, 2013

I got no eggs during egg collection – what went wrong ? Why were my follicles empty ?

There are some women who face this difficult situation when undergoing IVF. They take all their injections, their ovaries grow lots of follicles, and their estrogen level in the blood rises as it should - but on the day of egg collection , the doctor cannot retrieve any eggs from their follicles ! This is called Empty Follicle Syndrome (EFS) and can be heart-breaking for a patient. Why does this happen ?

  •  The hCG injection which is given to mature the follicles ( the “trigger shot”) was not taken at the right time. The follicles attain maturity 36 hours after taking the hCG injection. If the hCG is taken too early, the patient can ovulate her eggs before they can be collected. If the patient has taken the hCG shot too late, the eggs are not mature and these immature eggs cannot be flushed out of the follicles. So please ask the clinic staff for the exact time you need to take your hCG injection. If you fail to take the hCG shot at the proper time , please inform your doctor. 

  •  The hCG shot was not given properly. Some patients forget to dissolve the powder in the solvent – and take only the solvent – which is just sterile water ! This is not uncommon, because the HCG injection is often given in the middle of the night, when errors do occur. 

  • If your egg collection gets delayed past the 39 hour mark, you might ovulate , as a result of which the eggs are no longer present in the follicle. 

  • EFS can also be the result of an abnormality in the in-vivo biological activity of some batches of commercially available human chorionic gonadotrophin (HCG)

  •  In very rare cases there is an entity called genuine empty follicle syndrome where no known cause can be identified

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