Borderline form of empty follicle syndrome treated with a novel dual trigger method combined with delayed oocyte retrieval: A case report

Table 1 Assisted reproductive technique cycle description

Date	Gonadotrophin	Daily dosage	Total	GnRH analog	Ovulation trigger	Protocol	Estrogen level (pg/mL)	Oocyte no
December, 2016	HMG	225U	2475U	GnRH-ant (0.25 mg)	HCG 1000U	Antagonist, fixed	3101	M1 × 1
March, 2017	rFSH + HMG	75U+225U	900U + 2700U	GnRH-a (0.1 mg)	HCG 2000U + rHCG 250U	Agonist, short	4870	M1 × 1
June, 2019	rFSH + HMG + rLH	200U+75U+75U	2200U+ 825U + 825U	GnRH-a (0.05 mg)	GnRH (0.2 mg) rHCG + HCG 10000U	Agonist, long	3623	M I × 2 M II × 3

GnRH-a: Gonadotropin-releasing hormone agonist; GnRH-ant: Gonadotropin-releasing hormone antagonist; HCG: Human-chorionic gonadotropin; HMG: Human menopausal gonadotropin; rFSH: Recombinant human follicle stimulating hormone: rHCG: Recombinant human chorionic gonadotropin.

Table 2 Introduction to the third in vitro fertilization

Date	June 7, 2019	June 12, 2019	June 15, 2019	June 17, 2019	June 18, 2019	June 20, 2019
D (Gn)	24 (1)	29 (6)	32 (9)	34 (11)	35 (12)
E2 (pg/mL)	64	1120	2357	4146	3623
LH (IU/L)	1.79	2.19	1.42	1.49	1.03
P (ng/L)	0.82	1.01	0.78	1.28	1.48
RF (cm)	0.65, 0.2 × 10	1.2, 1.1 × 3, 1.0, 0.9 × 3	1.35 × 2, 1.25 × 3, 1.2 × 4, 0.95 × 3	1.7, 1.65, 1.55, 1.3 × 3, 1.15 × 3, 1.05 × 3, 0.9	1.9, 1.7 × 2, 1.6, 1.45, 1.4, 1.35, 1.3, 1.25 × 3, 1.15, 1.0	Total 10, ≥ 1.4
LF (cm)	0.6, 0.2 × 10	1.25, 1.15, 1.1, 0.8 × 2, 0.75 × 2, 0.6	1.65, 1.45, 1.25, 1.05, 0.95 × 2, 0.9, 0.85, 0.75, 0.6	1.7, 1.55, 1.5, 1.15 × 3, 0.95, 0.9, 0.7 × 2	1.75 × 2, 1.7, 1.4, 1.35, 1.2 × 3, 1.0 × 2
EM (cm)	1.21A-B	1.2B	1.38B	1.29B	1.13B
HMG	75U × 5	75U × 3	150U × 2	150U × 1
rFSH	200U × 5	200U × 3	200U × 2	200U × 1
rLH	75U × 5	75U × 3	75U × 2	75U × 1
Dydrogesterone	20 mg Bid	20 mg Bid	20 mg Bid	20 mg Bid
Ovulation trigger					rHCG 250U + GnRH-a 0.2 mg + HCG 10000U	39 h oocyte retrieval

Gn: Gonadotropin; RF: Right follicle; LF: Left follicle; EM: Endometrium; HCG: Human chorionic gonadotropin; HMG: Human menopausal gonadotropin; rFSH: Recombinant human follicle-stimulating hormone; rHCG: Recombinant human chorionic gonadotropin; rLH: Recombinant luteinizing hormone; P: Progesterone, E2: Estradiol.