Follicular flushing during oocyte retrieval in assisted reproductive techniques

Wongtra-ngan, Supreeya; Vutyavanich, Teraporn; Brown, Julie

doi:10.1002/14651858.cd004634.pub2

Cited by 44 publications

(31 citation statements)

References 14 publications

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“…They found that about 40 % of the oocytes are retrieved with primary aspiration without follicular flushing, while up to 82 % of oocytes are retrieved with two flushes and 97 % of oocytes up to four flushes and only 3 % of the remaining oocytes are retrieved with 5th and 6th flush [18]. In contrast a recent Cochrane review showed that with the utilization of proper retrieval techniques, most of the oocytes are retrieved without the need for follicle flushing [19,20]. However the issue of whether flushing should be not performed is still very much controversial and hotly debated (see discussions posted on www.IVFworldwide.com accessed January and February 2013).…”

Section: Discussionmentioning

confidence: 99%

Correlation between follicular diameters and flushing versus no flushing on oocyte maturity, fertilization rate and embryo quality

Mehri

Levi-Setti

Greco

et al. 2013

J Assist Reprod Genet

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Objective To determine (a) the correlation between follicular sizes, oocyte maturity, normal fertilization rate, cleavage and embryo quality; and (b) to establish whether oocytes recovered with or without follicular flushing have different developmental competence. Design Prospective observational study. Setting Academic medical center. Patients Forty nine cycles (37 ICSI and 12 IVF). Interventions Measurement of 360 follicular diameters on the day of egg retrieval and classification into three groups Group A (mean diameter 12-14.5 mm.), group B (mean diameter 15-18 mm.) and group C (diameter >18.5 mm.). Main outcome measure Correlation between follicular size at the time of retrieval and oocyte maturity, fertilization and cleavage rate in 226 oocytes (163 ICSI and 63 IVF). Developmental competence of oocytes retrieved with flushing versus non flushing. Results Almost all (99 %) of the oocytes recovered from follicles of group C were in metaphase II as opposed to 80 % in group A and 81 % in group B (p <0.01). Overall there was a progressive and significant increase in fertilization rates from group A follicles to group C (47 % vs. 67 %, p 0.05). Overall 53 % of oocytes retrieved from group A follicles showed either no fertilization or abnormal fertilization versus 27 % in group C (p 0.05). The oocyte recovery rate with follicular flushing improved from group A to group B and to group C follicles (65 % vs. 49 % vs.37 % respectively p <0.01). There were no differences in rates of immature oocyte, fertilization, abnormal or not fertilization and cleavage. Conclusions The results of this study shows that: a) Follicles larger than 18 mm at retrieval have consistently mature oocytes with a higher rate of fertilization; b) Small size follicles are still capable of containing mature oocytes, but their rate of abnormal or no fertilization is high; c) Oocytes recovered with flushing are still able to produce embryos with full developmental competence.

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Section: Discussionmentioning

confidence: 99%

Correlation between follicular diameters and flushing versus no flushing on oocyte maturity, fertilization rate and embryo quality

Mehri

Levi-Setti

Greco

et al. 2013

J Assist Reprod Genet

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“…Theoretically, follicular flushing should facilitate oocyte retrieval and should maximize the collection of oocytes [3] [4] [5] [6]. Nevertheless, with the development of oocyte retrieval technology, an increasing number of studies have found that skilled oocyte retrieval by direct aspiration can be used to obtain the vast majority of oocytes.…”

mentioning

confidence: 99%

“…Nevertheless, with the development of oocyte retrieval technology, an increasing number of studies have found that skilled oocyte retrieval by direct aspiration can be used to obtain the vast majority of oocytes. Conversely, the use of a DLN for follicular flushing would prolong the operative time, affect the fertilization of oocytes, and confer no benefit compared with the use of a single-lumen needle (SLN) [6] [7]. A meta-analysis published by Roque et al in 2012 concluded that in an unselected group of patients, there was no advantage in using a DLN in oocyte retrieval [8].…”

mentioning

confidence: 99%

Double-Lumen Needle Follicular Flushing System versus Single-Lumen Aspiration Needle in IVF/ICSI Patients with Poor Ovarian Response: A Meta-Analysis

Xing¹,

Ou²,

Cai³

et al. 2017

ASM

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Background: The present study performed a meta-analysis to comprehensively analyze existing randomized controlled trials (RCT) involving the use of double-lumen needle in patients with poor ovarian response to explore whether double-lumen needle was good for specific patients. Methods: The PubMed, EMBASE, Cochrane Library databases and two randomized controlled trials registration centers were thoroughly searched until April 2017. The clinical outcomes of IVF/ICSI cycles were compared between two groups with double-lumen needle and single-lumen needle. Results: Four RCT studies were included in this present meta-analysis. The oocytes yield was similar in two groups (OR 0.88,; I 2 = 4%). The procedure time with

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“…There have been several reviews on the effectiveness of follicular flushing in human IVF [11][12][13][14]. A comprehensive Cochrane review performed in 2010 [11] included four prospective randomized controlled trials with a total of 208 patients comparing aspiration alone with aspiration with flushing.…”

mentioning

confidence: 99%

“…A comprehensive Cochrane review performed in 2010 [11] included four prospective randomized controlled trials with a total of 208 patients comparing aspiration alone with aspiration with flushing. Essentially, none of the four studies demonstrated any increase in mean oocytes retrieved or fertilization rates achieved.…”

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confidence: 99%