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

The 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.

In this study, the authors have investigated the relationship between the Beta-Human chorionic gonadotropin (𝛽HCG) levels in the follicular fluid with or without the oocyte in the follicles of patients undergoing Intracytoplasmic Sperm Injection.

Seventy-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 𝛽HCG level, after which the 𝛽HCG levels were compared to the follicles with and without the oocyte in each patient.

In this study, the 𝛽HCG 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 𝛽HCG in the follicular fluids containing the oocyte were higher than without oocytes, This difference was not statistically significant (p = 0.16).

It seems that the follicular fluid 𝛽HCG isn’t caused by empty follicle syndrome, and that dysfunctional folliculogenesis may be the cause of this syndrome.