Assessment of the empty follicle syndrome by transvaginal sonography

Hilgers TW; Kimball CR; Keck SJ; Dvorak AD; Tamisiea DF; Yaksich PJ

doi:10.7863/jum.1992.11.7.313

Assessment of the empty follicle syndrome by transvaginal sonography

Hilgers TW, Kimball CR, Keck SJ, Dvorak AD, Tamisiea DF, Yaksich PJ

Published July 1992 Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine, 11(7), 313-316

DOI 10.7863/jum.1992.11.7.313 PMID 1522617

RRM Academy Synopsis

Empty follicle syndrome in 43.4% of infertility or miscarriage cases

A one-center ultrasound study of 152 women with infertility or repeated miscarriage found empty follicle syndrome in 43.4% of the women studied, about 4 out of 10. Cycles were unmedicated. The rate rose with age and did not vary with past pregnancies.

About 4 in 10 women with infertility or repeated miscarriage had empty follicle syndrome on ultrasound. Source: Hilgers TW et al., 1992, PMID 1522617.

Study at a glance, one-center ultrasound study of 152 women: Empty follicle syndrome appeared in 43.4% of women studied. Source: Hilgers TW et al., 1992, PMID 1522617.

Key Findings

The cumulus oophorus, the cell cluster that surrounds the egg, was absent in 66 of 152 women, a frequency of 43.4%.
It was absent in 35.8% of technically easy scans (29 of 81) and 52.1% of technically difficult scans (37 of 71). The difference was not statistically significant.
The cumulus was absent in 36.7% of women aged 29 or younger and 47.8% of women aged 30 or older.
Laparoscopy found endometriosis in 105 women and pelvic adhesions in 37. Frequency did not differ significantly by pathologic condition or by number of past pregnancies.
An earlier transabdominal ultrasound study of 89 women reported a prevalence of 50.0%.

Interpretation

This case series followed 152 women seen for infertility or repeated miscarriage at one fertility clinic. Empty follicle syndrome here means the cumulus oophorus, the cell cluster around the egg, was missing on ultrasound. The authors note the hormonal cause is not yet known. The findings support more study of why this happens and how common it is in larger groups of women.

RRM Context

The first reports of empty follicle syndrome came from women on ovulation-stimulating drugs. This study and the earlier one studied unmedicated cycles instead. Creighton Model charting times daily ultrasound scans around the follicle's rupture. Charting signs mark an ovulatory event. Ultrasound follows the follicle itself. Checking ovulation in the woman's own cycle fits the RRM principle of evaluating before treating.

Our editorial summary of this paper, not the article's abstract.

Abstract

The empty follicle syndrome was assessed using transvaginal ultrasonography in a group of 152 consecutive women with unmedicated menstrual cycles being studied because of primary or secondary infertility or repetitive miscarriage. The overall frequency of the empty follicle syndrome was found to be 43.4%. The frequency increased with age but was independent of gravidity. The empty follicle syndrome may be a significant etiologic factor in infertility or other reproductive abnormalities, and transvaginal ultrasound represents a good, non-invasive means of evaluating it.

Topics

Diagnostics › Ultrasound › Follicular Monitoring · Menstrual Cycle › Cycle Disorders › Ovulatory Disturbances

Thomas W Hilgers

Tom Hilgers, T Hilgers

PMID 1522617 1522617 DOI 10.7863/jum.1992.11.7.313 10.7863/jum.1992.11.7.313 Hilgers et al. 1992, Hilgers 1992

Keywords

Abortion, Spontaneous/diagnostic Imaging, Adult, Female, Follicular Atresia, Humans, Infertility, Female/diagnostic Imaging, Menstrual Cycle, Ovarian Diseases/diagnostic Imaging, Pregnancy, Prevalence, Prospective Studies, Syndrome, Ultrasonography

Assessment of the empty follicle syndrome by transvaginal sonography

Empty follicle syndrome in 43.4% of infertility or miscarriage cases

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

Related research

Keywords