Not only Empty follicle sounds empty and hollow ,it is follicles which are empty ,just filled with fluids and more fluids.It is strange that I am starting my blog with a rather negative post.But then these empty follicles do leave me empty for atlas 24 hours.I am sure it leaves the Lady empty for a longer duration or probably for life.

It has happened so many times.The lady is given Gonadotrophins in few hundred units and the infertility specialist and the lady are happy counting the growing follicles in the Ultrasound screen .Till the day of Ovum Pick up.When follicles after follicles,one after another,aspirated and are declared by the embryologist with no eggs.

Though not your fault ,as a doctor you feel guilty.It has costed a bomb to your patient and you tell her that it wasn’t successful.There are so many questions.Why? What happened?There were so many follicles.Follicles mean hope.Eggs within.The possibility of healthy embryo and then a BABY.

What goes wrong.Why After all do we have empty follicle.Who has the answer?Well there can Only be hypothesis.Every cycle there are 300 to 350 follicles which are destroyed by atresia.thats how nature wanted it .And these follicles which are destroyed are the unhealthy follicles.We make them grow by pumping hormones from outside.Sometimes we succeed ,sometimes we don’t.The unhealthy follicles meant for atresia don’t have egg within but just fluid.And there lies the answer.

At times ,it might a wrongly timed trigger ( be it HCG or be it GnRh Agonist).A properly timed trigger is a must for maturation of egg.It is just so crucial.The timing should be 36 hours approximately.A delayed trigger would mean immature follicles and an early one would mean loss of egg by ovulation.

Sometimes in PCOS patients the empty follicles are due to increased LH levels.

But what ever the reason ,it leaves with a empty hollow feeling….both for the patient and the doctor.