Sonographic definition of the empty follicle syndrome

Hilgers TW; Dvorak AD; Tamisiea DF; Ellis RL; Yaksich PJ

doi:10.7863/jum.1989.8.8.411

Sonographic definition of the empty follicle syndrome

Hilgers TW, Dvorak AD, Tamisiea DF, Ellis RL, Yaksich PJ

Published August 1989 Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine, 8(8), 411-416

DOI 10.7863/jum.1989.8.8.411 PMID 2668550

RRM Academy Synopsis

Half of infertile women's unmedicated cycles had an empty follicle

Ultrasound found no cumulus oophorous, the cell cluster around the egg, in about half of dominant follicles. This 1989 series scanned 87 women with infertility, most with endometriosis. The cycles were unmedicated. The authors call this the empty follicle syndrome. They suggest it may be a significant factor in infertility.

Study at a glance, single-center case series: About half of dominant follicles lacked the cumulus oophorous on ultrasound — Study at a glance, single-center case series of 87 women with infertility: About half of dominant follicles lacked the cumulus oophorous on ultrasound. Source: Hilgers TW et al., 1989, PMID 2668550.

Key Findings

Of 87 cycles in 87 women, 81 (93.1%) had a single dominant follicle. In six patients (6.8%), two or more follicles were tracked.
Among the 81 single-follicle cycles, the cumulus oophorous was present in 50.6% and absent in 49.4%.
In this series the absence of the cumulus increased with age. It appeared unrelated to past pregnancies and did not differ significantly by laparoscopic diagnosis or type of follicular rupture.
The cumulus was measured in 28 cycles, with a mean size of 5.5 mm the day before rupture. In 8 of the 28 it appeared only 3 to 5 days before.
On the day before rupture, mean follicle diameter was 2.27 cm with a cumulus and 2.18 cm without one (p = .3).

Interpretation

This single-center case series followed 87 women with infertility, most with endometriosis. The cycles were unmedicated and ran in 1989. Serial ultrasound tracked the dominant follicle to rupture. The cumulus oophorus was absent in close to half the cycles. The authors call this the empty follicle syndrome. They propose it as a factor in infertility. The authors note that the full-bladder technique and an expert ultrasound team were central to these results. The findings support larger studies of this syndrome.

RRM Context

Every woman charted her cycles with the Ovulation Method of Natural Family Planning. The charts set the days for serial scans. The authors raise a possibility. Women treated for endometriosis or adhesions may still fail to conceive because of an ovulation disorder. Charting plus direct ultrasound of the follicle looks for the cause of infertility. Restorative reproductive medicine builds on this.

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

Abstract

The sonographic definition of the empty follicle syndrome is presented in a group of 89 consecutive, unmedicated menstrual cycles in women with primary or secondary infertility. The incidence of the empty follicle syndrome was found to be 50%. The incidence increased with age and was independent of gravidity or the type of follicular rupture (or lack of rupture). These data suggest that the empty follicle syndrome may represent a significant etiologic factor in infertility or other reproductive abnormalities.

Topics

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

Thomas W Hilgers

Tom Hilgers, T Hilgers

PMID 2668550 2668550 DOI 10.7863/jum.1989.8.8.411 10.7863/jum.1989.8.8.411 Hilgers et al. 1989, Hilgers 1989

Keywords

Adult, Endometriosis/complications, Female, Follicular Phase, Humans, Infertility, Female/diagnosis/etiology, Ovarian Follicle, Ovulation, Pelvic Neoplasms/complications, Syndrome, Ultrasonography

Sonographic definition of the empty follicle syndrome

Half of infertile women's unmedicated cycles had an empty follicle

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

Related research

Keywords