Recurrent Genuine Empty Follicle Syndrome: Diagnostic Dilemma and Management Challenges – A Case Report

Empty follicle syndrome (EFS) is a rare condition characterised by failure to retrieve oocytes despite adequate ovarian response and normal hormonal profiles. We report a 22-year-old woman with recurrent genuine EFS, experiencing no oocyte retrieval in two consecutive in vito fertilisation (IVF) cycles despite proper ovarian stimulation, correct retrieval timing, and double-trigger administration in the second cycle. False EFS was excluded by confirming adequate β-human chorionic gonadotropin levels on retrieval day. A potential genetic aetiology was considered; however, the patient declined genetic evaluation and chose oocyte donation instead. This case underscores the diagnostic challenges of genuine EFS, emphasising the importance of ruling out false EFS through rigorous clinical and hormonal assessment. Multicentric systematic studies are essential to elucidate the aetiology and optimal management strategies for EFS.