Evaluation of follicular fluid's Beta-Human chorionic gonadotropin in the follicles of patient undergoing Intracytoplasmic sperm injection: A cross-sectional study.

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This cross-sectional study found no statistically significant difference in follicular fluid β-hCG levels between oocyte-containing and empty follicles in patients undergoing intracytoplasmic sperm injection, suggesting dysfunctional folliculogenesis rather than β-hCG deficiency causes empty follicle syndrome.

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This cross-sectional study evaluated whether beta-human chorionic gonadotropin levels in follicular fluid serve as a marker for Empty Follicle Syndrome among 73 women undergoing intracytoplasmic sperm injection. Researchers compared hCG concentrations in follicles containing oocytes versus those that were empty, while explicitly excluding patients with endometriosis to isolate other infertility factors. The analysis revealed no statistically significant difference in hCG levels between the two groups, indicating that hCG does not predict oocyte presence and suggesting that dysfunctional folliculogenesis rather than hCG deficiency causes the syndrome. Relevance to endometriosis: The paper explicitly excludes patients with endometriosis from its study population, meaning it does not provide data on the condition but is relevant by defining exclusion criteria for research into assisted reproductive technologies.

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Abstract

BackgroundThe failure to retrieve oocytes from mature ovarian follicles is referred to as empty follicle syndrome. There is no exact explanation to this problem and it cannot be predicted using ultrasound or serum hormonal levels. The underlying mechanism of Empty follicle syndrome remains obscure.ObjectiveIn this study, the authors have investigated the relationship between the Beta-Human chorionic gonadotropin ( β HCG) levels in the follicular fluid with or without the oocyte in the follicles of patients undergoing Intracytoplasmic Sperm Injection.Materials and methodsSeventy-three infertile couples underwent standard long protocol induction ovulation for Intracytoplasmic sperm injection. On the day of oocyte retrieval, each patient had two samples; follicular fluid including 2-3 follicles with oocyte and follicular fluid including of 2-3 follicles without oocyte were collected in separate tubes. These follicles had similar shape and size. The Samples were transferred to a laboratory for measuring the β HCG level, after which the β HCG levels were compared to the follicles with and without the oocyte in each patient.ResultsIn this study, the β HCG level of follicular fluid in the follicles containing oocyte was 18.20 (8.35-42.92) IU/L and in the follicles without the oocyte was 13.50 (5.45-25.81) IU/L. Levels of β HCG in the follicular fluids containing the oocyte were higher than without oocytes, This difference was not statistically significant (p = 0.16).ConclusionIt seems that the follicular fluid β HCG isn't caused by empty follicle syndrome, and that dysfunctional folliculogenesis may be the cause of this syndrome.
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The low sample size and the lack of a similar study to compare with our study are the limitations of our study.

Coi Statement

It should be noted that there was no association between the authors and any organization or institution. The authors report no declarations of interest.

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