An empty puncture is a situation in which no oocytes are retrieved during an ovarian punction even though there is a correct growth in the follicles. When we encounter this situation we refer to it as Empty Follicle Syndrome.
Some studies show this can occur in up to 7% of patients that undergo IVF, even though the vast majority of cases can be explained by problems in the hormonal treatment (incorrect administration, outdated HCG...). It is estimated that True Empty Follicle Syndrome is only present in 0.02% of patients.
The causes for this Syndrome are unknown but it is thought that alterations in the folliculogenesis (formation of the follicles and ovules) could be the main cause. These alterations can be caused by advanced maternal age, bad ovarian quality, or genetic factors.
This could cause:
- An early degeneration of the oocytes explaining the lack of them in the punction.
- Lack of detachment of the oocyte from the follicle wall. During ovulation, the luteinizing hormone triggers a series of mechanisms that imply the softening of the follicle´s adhesive tissue, allowing the oocyte to detach from the follicle wall.
Another suggestion we can find is the repetition of the cycle with recombinant hCG, luteinizing hormone, or the trigger of ovulation with the liberation of an agonist of the gonadotropin hormone. If after all of these suggestions the problem persists, ovodonation could be an option.