4.6 Review

Empty follicle syndrome revisited: definition, incidence, aetiology, early diagnosis and treatment

Journal

REPRODUCTIVE BIOMEDICINE ONLINE
Volume 35, Issue 2, Pages 132-138

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.rbmo.2017.04.012

Keywords

In-vitro fertilization; Oocyte retrieval; Ovarian follicle; Ovarian stimulation; Ovulation trigger

Ask authors/readers for more resources

In this review, the definition, incidence and possible causes of empty follicle syndrome (EFS), including molecular mechanisms that may underlie the syndrome, are discussed, along with prevention and treatment options. EFS is the complete failure to retrieve oocytes after ovarian stimulation, despite apparently normal follicle development and adequate follicular steroidogenesis. Two variants of EFS have been described: the 'genuine' form (gEFS), which occurs in the presence of adequate circulating HCG levels at the time of oocyte aspiration, and the 'false' form (f-EFS), which is associated with circulating HCG below a critical threshold. Heterogeneous HCG concentration thresholds, however, have been used to define gEFS, and to date no standardization exist. The situation is unclear when GnRH-analogues are used for ovulation trigger, as the threshold circulating LH and progesterone levels used to define EFS as 'genuine' are not established. The cause of fEFS has been clearly identified as an error in HCG administration at the time of ovulation trigger; in contrast, the cause of gEFS is still unclear, although some pathogenetic hypotheses have been proposed. Optimal treatment and prognosis of these patients are still poorly understood. Large, systematic multi-centre studies are needed to increase the understanding of EFS. (C) 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.6
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

Article Biochemistry & Molecular Biology

Quinagolide Treatment Reduces Invasive and Angiogenic Properties of Endometrial Mesenchymal Stromal Cells

Corinne Iampietro, Alessia Brossa, Stefano Canosa, Stefania Tritta, Glenn E. Croston, Torsten Michael Reinheimer, Filippo Bonelli, Andrea Roberto Carosso, Gianluca Gennarelli, Stefano Cosma, Chiara Benedetto, Alberto Revelli, Benedetta Bussolati

Summary: Quinagolide inhibits the invasive properties of endometrial mesenchymal stromal cells (E-MSCs) in endometriosis, but has no effect on their proliferation and limits their endothelial differentiation. These effects are mediated through activation of a specific dopamine receptor and are independent of VEGFR2 inhibition. The effects are more prominent in ectopic E-MSCs. These findings increase the rationale for the use of quinagolide in endometriosis treatment.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2022)

Article Genetics & Heredity

Are commercial warming kits interchangeable for vitrified human blastocysts? Further evidence for the adoption of a Universal Warming protocol

Stefano Canosa, Lodovico Parmegiani, Lorena Charrier, Gianluca Gennarelli, Cristina Garello, Francesca Granella, Francesca Evangelista, Giuseppe Monelli, Daniela Guidetti, Alberto Revelli, Marco Filicori, Francesca Bongioanni

Summary: This study found no significant differences in the clinical effectiveness of different combinations of warming kits for vitrified human blastocysts, supporting the efficacy of a single warming protocol.

JOURNAL OF ASSISTED REPRODUCTION AND GENETICS (2022)

Article Medicine, General & Internal

Women in Advanced Reproductive Age: Are the Follicular Output Rate, the Follicle-Oocyte Index and the Ovarian Sensitivity Index Predictors of Live Birth in an IVF Cycle?

Andrea Roberto Carosso, Rik van Eekelen, Alberto Revelli, Stefano Canosa, Noemi Mercaldo, Chiara Benedetto, Gianluca Gennarelli

Summary: None of FORT, FOI and OSI are independent predictors of live birth in women of advanced reproductive age. These three metrics are not more informative than the 'component' characteristics that are used to calculate them.

JOURNAL OF CLINICAL MEDICINE (2022)

Article Biochemistry & Molecular Biology

A Novel Xeno-Free Method to Isolate Human Endometrial Mesenchymal Stromal Cells (E-MSCs) in Good Manufacturing Practice (GMP) Conditions

Stefano Canosa, Katia Mareschi, Elena Marini, Andrea Roberto Carosso, Sara Castiglia, Deborah Rustichelli, Ivana Ferrero, Gianluca Gennarelli, Benedetta Bussolati, Alberto Nocifora, Valentina Asnaghi, Massimiliano Bergallo, Ciro Isidoro, Chiara Benedetto, Alberto Revelli, Franca Fagioli

Summary: The study compared two different endometrial sampling methods and validated a novel xeno-free method for culturing human E-MSCs. Results showed that VABRA endometrial sampling could be an alternative to surgical curettage, providing efficient isolation and culture of E-MSCs in Good Manufacturing Practice compliance conditions.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2022)

Article Medicine, General & Internal

Are There Ovarian Responsive Indexes That Predict Cumulative Live Birth Rates in Women over 39 Years?

Sara Cesarano, Paul Pirtea, Achraf Benammar, Dominique De Ziegler, Marine Poulain, Alberto Revelli, Chiara Benedetto, Alexandre Vallee, Jean Marc Ayoubi

Summary: This study aimed to evaluate the performance of ovarian response indexes in predicting cumulative assisted reproductive technology (ART) outcomes in women aged 39 and above. The study found that the Ovarian Sensitivity Index (OSI) performed the best in predicting cumulative live birth rate (cLBR) and implantation rate, while the Follicle Oocyte Index (FOI) and Follicular Output Rate (FORT) were also associated with embryo culture success and the number of MII oocytes collected.

JOURNAL OF CLINICAL MEDICINE (2022)

Article Biochemistry & Molecular Biology

Increased Placental Anti-Oxidant Response in Asymptomatic and Symptomatic COVID-19 Third-Trimester Pregnancies

Alessandro Rolfo, Stefano Cosma, Anna Maria Nuzzo, Chiara Salio, Laura Moretti, Marco Sassoe-Pognetto, Andrea Roberto Carosso, Fulvio Borella, Juan Carlos Cutrin, Chiara Benedetto

Summary: This study observed oxidative stress and mitochondrial pathological changes in the placenta of pregnant women with SARS-CoV-2 infection during the third trimester, but the pregnant women maintained a good physiological state. This suggests that the placenta has a certain inhibitory effect on oxidative stress during SARS-CoV-2 infection.

BIOMEDICINES (2022)

Article Nutrition & Dietetics

Pregnancy and COVID-19: The Possible Contribution of Vitamin D

Alessandra Manca, Stefano Cosma, Alice Palermiti, Martina Costanzo, Miriam Antonucci, Elisa Delia De Vivo, Alice Ianniello, Fulvio Borella, Andrea Roberto Carosso, Silvia Corcione, Francesco Giuseppe De Rosa, Chiara Benedetto, Antonio D'Avolio, Jessica Cusato

Summary: This is the first study demonstrating the role of vitamin D in affecting the clinical characteristics of pregnant women during the COVID-19 era. Vitamin D-related polymorphisms can affect vitamin D levels in both SARS-CoV-2 positive and negative patients. Vitamin D levels were lower in preterm births among SARS-CoV-2 positive patients.

NUTRIENTS (2022)

Review Obstetrics & Gynecology

Opening the black box: why do euploid blastocysts fail to implant? A systematic review and meta-analysis

Danilo Cimadomo, Laura Rienzi, Alessandro Conforti, Eric Forman, Stefano Canosa, Federica Innocenti, Maurizio Poli, Jenna Hynes, Laura Gemmell, Alberto Vaiarelli, Carlo Alviggi, Filippo Maria Ubaldi, Antonio Capalbo

Summary: The normal chromosomal constitution determined by PGT-A is the strongest predictor for embryo implantation, but its positive predictive value is limited. The causes of reproductive failure in euploid blastocysts, known as "the black box of implantation," are not well understood.

HUMAN REPRODUCTION UPDATE (2023)

Review Nutrition & Dietetics

COVID-19 in Pregnancy: Influence of Body Weight and Nutritional Status on Maternal and Pregnancy Outcomes-A Review of Literature and Meta-Analysis

Rossella Attini, Maria Elena Laudani, Elisabetta Versino, Alessio Massaro, Arianna Pagano, Francesca Petey, Alberto Revelli, Bianca Masturzo

Summary: Based on research findings, being pregnant does not increase the risk of COVID-19 infection, but it may lead to more severe complications for both the mother and the fetus. This study found that obesity is associated with a higher risk of severe infection, maternal death, and hospital admission for pregnant women with COVID-19. The level of micronutrients, especially Vitamin D, appears to be lower in COVID-19-positive pregnant women.

NUTRIENTS (2023)

Article Medicine, General & Internal

Gestational Diabetes Mellitus Does Not Worsen Obstetrical and Neonatal Outcomes of Twin Pregnancy

Alice Ronco, Sofia Roero, Silvana Arduino, Arianna Arese, Isabella Ferrando, Gabriella Scaltrito, Viola Casula, Teresa Fea, Mattia Mazza, Carlotta Bossotti, Roberto Zizzo, Alberto Revelli

Summary: This study analyzed the specific effects of gestational diabetes mellitus (GDM) on twin pregnancy outcomes. The results showed that compared to GDM singleton pregnancies, GDM twins had higher rates of preeclampsia, cesarean section, and neonatal hypoglycemia. Compared to twin pregnancies without GDM, women with GDM twins were older, had higher BMI, had a higher incidence of large-for-gestational-age (LGA) newborns, and a lower incidence of low APGAR scores. Overall, GDM does not worsen outcomes of twin pregnancy.

JOURNAL OF CLINICAL MEDICINE (2023)

Article Medicine, General & Internal

Reproductive and Obstetric Outcomes Following a Natural Cycle vs. Artificial Endometrial Preparation for Frozen-Thawed Embryo Transfer: A Retrospective Cohort Study

Andrea Roberto Carosso, Nicole Brunod, Claudia Filippini, Alberto Revelli, Bernadette Evangelisti, Stefano Cosma, Fulvio Borella, Stefano Canosa, Chiara Benedetto, Gianluca Gennarelli

Summary: This study compared reproductive and obstetric outcomes of frozen embryo transfer using different endometrial preparation strategies. The results showed no significant differences in reproductive outcomes between natural/modified cycle and artificial cycle groups. However, pregnancies achieved after artificial endometrial preparation were associated with increased risks of pregnancy-induced hypertension and abnormal placental insertion.

JOURNAL OF CLINICAL MEDICINE (2023)

Article Health Care Sciences & Services

Induction of Labor in Women with Previous Cesarean Section and Unfavorable Cervix: A Retrospective Cohort Study

Chiara Germano, Ilenia Mappa, Antonella Cromi, Enrico Busato, Maddalena Incerti, Andrea Lojacono, Giuseppe Rizzo, Rossella Attini, Lodovico Patrizi, Alberto Revelli, Bianca Masturzo

Summary: This retrospective cohort study evaluated the use of a cervical ripening balloon (CRB) in women with a previous cesarean section and unfavorable Bishop score. The results showed that CRB induction of labor was safe and effective, with a vaginal birth rate of 57.3% and minimal side effects.

HEALTHCARE (2023)

Review Health Care Sciences & Services

Innovative Strategies for Fertility Preservation in Female Cancer Survivors: New Hope from Artificial Ovary Construction and Stem Cell-Derived Neo-Folliculogenesis

Stefano Canosa, Alberto Revelli, Gianluca Gennarelli, Gennaro Cormio, Vera Loizzi, Francesca Arezzo, Easter Anna Petracca, Andrea Roberto Carosso, Danilo Cimadomo, Laura Rienzi, Alberto Vaiarelli, Filippo Maria Ubaldi, Erica Silvestris

Summary: Recent advances in anticancer treatment have greatly improved the survival rate of young females, but one third of cancer survivors still face the risk of ovarian insufficiency and infertility. Several procedures have been developed to preserve fertility, including ovarian surgical transposition, gonadotropin-releasing hormone agonists (GnRH-a) treatment, and oocyte and/or ovarian cortical tissue cryopreservation. Innovative techniques, such as the construction of an artificial ovary and the use of stem cells for neo-folliculogenesis and oocyte development, are under investigation. These techniques offer potential strategies for oncofertility programs and provide hope for young female cancer survivors.

HEALTHCARE (2023)

Article Obstetrics & Gynecology

Gym lifestyle factors and male reproductive health: a study into young adult usage and perceptions

Alice Newman-Sanders, Jackson C. Kirkman-Brown, Meurig T. Gallagher

Summary: This study revealed a significant lack of awareness among young adults in the UK regarding the potential impacts of gym lifestyles and supplementation on male infertility. Men were found to have a concerning lack of concern for their own fertility, with differences in awareness levels between men and women. It was also observed that men were more likely to consider making changes to their behavior if it had a long-term impact on their fertility compared to short-term effects.

REPRODUCTIVE BIOMEDICINE ONLINE (2024)

Article Obstetrics & Gynecology

An artificial intelligence-based approach for selecting the optimal day for triggering in antagonist protocol cycles

Shachar Reuvenny, Michal Youngster, Almog Luz, Rohi Hourvitz, Ettie Maman, Micha Baum, Ariel Hourvitz

Summary: Using a machine-learning model to determine the optimal trigger days can improve the outcomes of antagonist protocol cycles in freeze-all or fresh transfer cycles, for all age groups. Implementing these models can more accurately predict the number of retrieved oocytes, optimizing physicians' decisions, balancing workloads, and creating more standardized yet patient-specific protocols.

REPRODUCTIVE BIOMEDICINE ONLINE (2024)

Article Obstetrics & Gynecology

Endometrial protein expression and phosphorylation landscape decipher aberrant insulin and mTOR signalling in patients with recurrent pregnancy loss

Chao Chen, Qi Wen, Feng Deng, Rong Li, Ying Wang, Xiumei Zhen, Jing Hang

Summary: This study investigates the proteomic and phosphoproteomic differences in the endometrium of women with recurrent pregnancy loss (RPL) compared to healthy control women during different phases of the menstrual cycle. The results identify differentially expressed proteins and phosphorylated proteins, and highlight the insulin/cyclic nucleotide signalling pathway and AMPK/mTOR signalling pathway as major contributors to the abnormality of RPL endometrium. The findings provide insights into potential proteins associated with the pathogenesis of RPL and contribute to the identification of potential targets for RPL treatment.

REPRODUCTIVE BIOMEDICINE ONLINE (2024)

Article Obstetrics & Gynecology

Random-start ovarian stimulation in an oocyte donation programme: a large, single-centre, experience

Jaime Guerrero, Juan Carlos Castillo, Jorge Ten, Jose Antonio Ortiz, Belen Lledo, Domingo Orozco, Francisco Quereda, Andrea Bernabeu, Rafael Bernabeu

Summary: The study found no significant differences in clinical outcomes between using oocytes obtained from random-start protocols and those from conventional ovarian stimulation in oocyte donation treatments. Luteal-phase stimulation required longer stimulation and higher FSH consumption.

REPRODUCTIVE BIOMEDICINE ONLINE (2024)