A case of empty follicle syndrome who conceived after aspiration of an endometrial cyst
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CASE REPORT
A case of empty follicle syndrome who conceived after aspiration of an endometrial cyst Rieko Tanaka • Mariko Murase • Yoshino Aizawa • Miwa Segino • Yumi Ishidera • Masakazu Kitagawa • Kayo Katayama • Kunitomo Takashima Yasushi Yumura • Hiroshi Yoshida • Hideya Sakakibara • Fumiki Hirahara
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Received: 25 February 2013 / Accepted: 25 March 2013 / Published online: 13 April 2013 Ó Japan Society for Reproductive Medicine 2013
Abstract Empty follicle syndrome (EFS) has been defined as a condition where no oocytes can be retrieved for in vitro fertilization (IVF) even though ultrasound findings and estradiol (E2) levels suggest the presence of potential follicles. The EFS is a rare condition with an incidence of 0.5–7 % of women undergoing IVF treatments. Although there are many hypotheses as to the cause of EFS, including advanced ovarian age, drug-related problems, and dysfunctional folliculogenesis, its cause remains unknown. A 37-year-old woman with endometriosis and a 5-year history of primary infertility underwent IVF treatment for 4 cycles. No oocytes were retrieved in 2 cycles and no fertilized eggs were obtained in the other 2 cycles. We assumed that endometriosis adversely affected folliculogenesis and fertilization. Aspiration of an endometrial cyst in the right ovary and subsequent administration of oral contraceptives resulted in successful folliculogenesis and fertilization. Thereafter, she conceived and delivered a 2,662 g female infant at 38 weeks of gestation. Here, we report a case of EFS who conceived in the 5th IVF cycle after aspiration of an endometrial cyst. We assumed that
R. Tanaka M. Murase Y. Aizawa M. Segino Y. Ishidera M. Kitagawa K. Katayama K. Takashima H. Yoshida Department of Obstetrics and Gynecology, Yokohama City University Medical Center, 4-57 Urafunecho, Minami Ward, Yokohama, Kanagawa 232-0024, Japan Y. Yumura Department of Urology, Yokohama City University Medical Center, 4-57 Urafunecho, Minami Ward, Yokohama, Kanagawa 232-0024, Japan H. Sakakibara (&) F. Hirahara Department of Obstetrics and Gynecology, Yokohama City University, 3-9 Fukuura, Kanazawa Ward, Yokohama, Kanagawa 236-0004, Japan e-mail: [email protected]
endometriosis might have been involved in the dysfunction of folliculogenesis and EFS. Keywords Dysfunction of folliculogenesis Empty follicle syndrome Endometriosis IVF–ET Oocyte–cumulus complex
Introduction Empty follicle syndrome (EFS) has been defined as a condition where no oocytes are retrieved from mature ovarian follicles after induction of ovulation for in vitro fertilization (IVF), even though ultrasound findings and estradiol (E2) levels suggest the presence of many potential follicles [1]. Although EFS is a rare condition, with an incidence of 0.5–7 % of women undergoing IVF treatments [2–4], it is a frustrating condition for both patients and medical staff. There are many hypotheses regarding the cause of EFS, such as advanced ovarian age [4, 5], drug-related problems [6], inheritance [7–9], and dysfunc
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