1. Common causes of empty follicles
①  Drug factors
Improper use of ovulation inducing drugs (such as insufficient dose or abnormal metabolism) may lead to asynchronous development of follicles, and some follicles may be atresized prematurely but remain normal in appearance. In addition, deviations in the injection time or insufficient dose of HCG (night needle) will affect the separation of oocytes and granulosa cells, resulting in failed egg retrieval.
② Ovarian function abnormal
Ovarian reserve is reduced (such as advanced age, premature aging) or in the presence of polycystic ovarian syndrome (PCOS), follicles may be unable to release eggs due to defective granulosa cell function.
(,)(PCOS),.Genetic factors, such as LH/HCG receptor mutations, may also cause premature occlusion of the oocyte.
③ Endocrine disorders
Abnormal levels of hormones such as estrogen and LH can interfere with follicular maturation signals, leading to a disconnect between egg development and follicular growth .
Abnormal levels of hormones such as estrogen and LH can interfere with the signaling process that promotes follicle maturation, resulting in a disruption between egg development and follicle growth.
④ Natural lock of the egg
Thereis occasionally natural atresia of follicles during the normal menstrual cycle, but drug stimulation may amplify this phenomenon when promoting ovulation in vitro.
During a normal menstrual cycle, it is possible for follicles to naturally degenerate. However, the use of medications during in vitro fertilization procedures may exacerbate this phenomenon.
2. How to reduce the risk of empty follicles?
Second, how can we reduce the risk of empty follicles?
Doctorswill adjust the type and dose of drugs based on ovarian reserve and hormone levels, and extend the ovulation promotion cycle if necessary.
Doctors will adjust the type and dosage of medications based on the ovarian reserve and hormone levels. If necessary, the cycle for ovulation induction may be extended.
● Precise monitoring and medication
Dynamic monitoring of follicular development through B-ultrasound and blood hormones, combined with AMH to assess ovarian function, and timely adjust the timing of HCG injection .
By using ultrasound and dynamic hormone monitoring to track follicle development, combined with AMH testing to assess ovarian function, we can accurately adjust the timing of HCG injection.
● Improve egg quality

Lifestyle: Avoid staying up late, quit smoking and limit alcohol consumption, and supplement antioxidants such as coenzyme Q10 and vitamin D.
Lifestyle: Avoid staying up late, quit smoking and limit alcohol consumption. It’s also important to supplement with antioxidants such as CoQ10 and vitamin D.
Traditional Chinese medicine treatments such as acupuncture and herbal remedies can improve ovarian blood flow and the maturity of oocytes.
Useindividualized egg retrieval time (such as extending HCG to 38-40 hours), or try a second egg retrieval (some empty follicles may expel eggs after 24 hours) .
Individualized timing of egg retrieval can be adopted (for example, the effect of HCG can be extended to 38-40 hours), or two attempts at egg retrieval can be made (some empty follicles may release eggs after 24 hours).
3. Important reminder
The incidence of empty follicles is about 5%-10%, which is not absolutely impossible to succeed.
5%-10%,.Even if the first egg retrieval is empty, there is still a chance to retrieve the eggs by adjusting the plan. If empty follicles occur repeatedly, it is recommended to investigate for genetic factors or immune problems and consider alternative options such as egg donation.