Snaifer Elie, Hugues Jean Noël, Poncelet Christophe, Sifer Christophe, Pasquier Maud, Cedrin-Durnerin Isabelle
Reproductive Medicine Unit, Jean Verdier Hospital, AP-HP, University Paris XIII, Bondy, France.
Fertil Steril. 2008 Sep;90(3):850.e13-5. doi: 10.1016/j.fertnstert.2007.08.008. Epub 2008 Jul 21.
To report a case of empty follicle syndrome (EFS) after human error occurring in hCG administration and discuss the specific management of this event in a GnRH antagonist cycle.
Case report.
A university hospital.
PATIENT(S): A 27-year-old woman admitted for a first oocyte retrieval resulting in empty follicle syndrome. The cause was the lack of administration of hCG injection 36 hours earlier.
MAIN OUTCOME MEASURE(S): Serial measurements of hCG, LH, and P.
RESULT(S): Because no injection of GnRH antagonist had been given for 2 days, the occurrence of endogenous LH surge was assessed by measurement of serum LH, P, and E(2). In the absence of any spontaneous LH surge, EFS was successfully treated by administering 250 microg of recombinant hCG in the evening of the first failed ovarian puncture and rescheduling the second oocyte retrieval 36 hours later. Four oocytes were retrieved and two resulting embryos were transferred. Pregnancy was obtained and patient gave birth to a healthy male baby at term.
CONCLUSION(S): Our case is the first report of pregnancy obtained after a successful treatment of EFS in a GnRH antagonist cycle. In contrast to GnRH agonist down-regulated cycles, the management of EFS in GnRH antagonist cycles has to take into account the possible occurrence of spontaneous endogenous LH surge.
报告1例因hCG给药人为失误导致的空卵泡综合征（EFS）病例，并探讨在GnRH拮抗剂周期中该事件的具体处理方法。
病例报告。
一所大学医院。
一名27岁女性因首次取卵导致空卵泡综合征入院。原因是36小时前未注射hCG。
连续测定hCG、LH和P。
由于2天未注射GnRH拮抗剂，通过测定血清LH、P和E₂评估内源性LH峰的发生情况。在未出现任何自发性LH峰的情况下，在首次卵巢穿刺失败当晚给予250μg重组hCG，并在36小时后重新安排第二次取卵，成功治疗了EFS。获取了4个卵母细胞，移植了2个由此形成的胚胎。患者成功妊娠并足月产下一名健康男婴。
我们的病例是GnRH拮抗剂周期中EFS成功治疗后获得妊娠的首例报告。与GnRH激动剂下调周期不同，GnRH拮抗剂周期中EFS的处理必须考虑到可能出现的自发性内源性LH峰。
