Table 1.
Clinical features of cases with EFS and oocyte anomalies
| Characteristic | Patient 1 | Patient 2 | |
|---|---|---|---|
| Age (years) | 25 | 28 | |
| Length of primary infertility history (years) | 4 | 4 | |
| Basal sexual hormone | FSH (IU/L) | 10.24 | 8.11 |
| LH (IU/L) | 8.85 | 2.93 | |
| E2 (ng/L) | 29.00 | 20.00 | |
| AMH (ng/mL) | 1.33 | 6.23 | |
| Pelvic ultrasound | Normal uterus, ovaries of equal sizes (left, 7.83 mL; right, 7.49 mL) | Normal uterus, ovaries of equal sizes (left, 2.37 mL; right, 2.67 mL) | |
| Cycle 1 | Protocol | GnRH antagonist | Short |
| Total dose of gonadotropin (IU) | 1875 | 1650 | |
| E2 level on trigger day (ng/L) | 2126 | 4346 | |
| No .of follicles ≥ 18 mm on trigger day | 2 | 9 | |
| Time interval between hCG administration and oocyte retrieval (h) | 36 | 36 | |
| Ovulation triggering (dose) | 10,000 IU (hCG) | 4000 IU (hCG) | |
| No. of oocytes retrieved | 0 (only a little granulosa cells cumulus) | 0 (only some granulosa cumulus cells) | |
| Serum hCG level (IU/L) on the day of OPU | 207.08 | 65.55 | |
| Cycle 2 | Protocol | GnRH antagonist | Long |
| Total dose of gonadotropin (IU) | 3825 | 1800 | |
| E2 level on trigger day (ng/L) | 2257 | 5110 | |
| No. of follicles ≥ 18 mm on trigger day | 1 | 3 | |
| Time interval between hCG administration and oocyte retrieval (h) | 36 and 39 | 36, 38 and 41 | |
| Ovulation triggering (dose) | 10,000 IU (hCG) + 0.2 mg (GnRH agonist) | 5000 IU (hCG) | |
| No. of oocytes retrieved | 0 (only a little granulosa cells cumulus) | 0, 0 (only a little granulosa cells cumulus) and 5 degenerated oocytes | |
| Serum hCG level (IU/L) on the day of OPU | NA | 111.50 | |
| Cycle 3 | Protocol | Natural | |
| Total dose of gonadotropin (IU) | 0 | ||
| E2 level on trigger day (ng/L) | 242 | ||
| No. of follicles ≥ 18 mm on trigger day | 0 (one follicle ≥ 14 mm) | ||
| Time interval between hCG administration and oocyte retrieval (h) | 36 | ||
| Ovulation triggering (dose) | 0.1 mg (GnRH agonist) | ||
| No. of oocytes retrieved | 1 (cumulus-oocyte complexes) | ||
| Cycle 4 | Protocol | Mild | |
| Total dose of gonadotropin (IU) | 1312 | ||
| E2 level on trigger day (ng/L) | 658 | ||
| No. of follicles ≥ 18 mm on trigger day | 0 (one follicle≥ 14 mm) | ||
| Time interval between hCG administration and oocyte retrieval (h) | 36 | ||
| Ovulation triggering (dose) | 0.2 mg (GnRH agonist) | ||
| No. of oocytes retrieved | 1 (zona pellucida free) | ||
| Cycle 5 | Protocol | Luteal phase ovarian stimulation | |
| Total dose of gonadotropin (IU) | 1800 | ||
| E2 level on trigger day (ng/L) | 1083 | ||
| No. of follicles ≥ 18 mm on trigger day | 1 | ||
| Time interval between hCG administration and oocyte retrieval (h) | 36 | ||
| Ovulation triggering (dose) | 10,000 IU (hCG) + 0.2 mg (GnRH agonist) | ||
| No. of oocytes retrieved | 0 (without granulosa cells cumulus) | ||
| Serum hCG level (IU/L) on the day of OPU | 177.62 | ||
EFS empty follicle syndrome, FSH follicle stimulating hormone (normal range 3.85–8.78 IU/L), LH luteinizing hormone (normal range 2.12–10.89 IU/L), E2 estradiol (normal range 27–122 pg/mL), AMH anti-Mullerian hormone (normal range 0.24–11.78 ng/mL), OPU ovum pick up, NA no data available, GnRH agonist (Diphereline®, Ipsen, France), GnRH antagonist (Orgalutran®, Organon, Netherlands), hCG (Livzon, China)