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Archives of Gynecology and Obstetrics

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01-10-2012 | Reproductive Medicine

Is follicular flushing really effective? A clinical study

Authors: Mustafa Kara, Turgut Aydin, Nurettin Turktekin

Published in: Archives of Gynecology and Obstetrics | Issue 4/2012

Abstract

Purpose

Oocyte retrieval under transvaginal ultrasonographic guidance has been used for in vitro fertilization-intracytoplasmic sperm injection. Despite considerable advances in the assisted reproductive techniques, the efficacy of follicular flushing during egg collection remains controversial. The aim of this study was to compare the follicular aspiration only and aspiration + flushing methods in terms of retrieved oocyte number and clinical pregnancy rates.

Materials and methods

A total of 200 patients were randomly divided into the intervention and control groups. All the patients underwent long protocol. Oocyte retrieval was performed when the dominant follicle reached 17 mm. Aspiration was performed using a single- or double-lumen catheter. Follicular flushing was performed after follicular aspiration in 100 patients of the intervention group. In the control group, only follicular aspiration was performed.

Results

There were no detected differences in the retrieved oocyte number. Although the clinical pregnancy rate in the intervention group was higher than the control group (40 vs. 33 %), the difference was not statistically significant. Cycle cancelation rate was lower in follicular flushing group (8 %) than control group (11 %) but, this difference was not statistically significant. Metaphase I (MI), germinal vesicle numbers were higher in group 1 than in group 2 and the differences were not statistically significant, either. Total operation time was longer in aspiration + flushing group (group 2) than aspiration only group (group 1) and the difference was statistically significant (p = 0.02).

Conclusion

In conclusion, our results indicate that follicular flushing during oocyte retrieval does not improve the retrieved oocyte number or clinical pregnancy rate but, it significantly increases the duration of procedure.

Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A (2011) Association between the number of eggs and live birth in IVF treatment: an analysis of 400 135 treatment cycles. Hum Reprod 26(7):1768–1774PubMedCrossRef

El Hussein E, Balen AH, Tan SL (1992) A prospective study comparing the outcome of oocytes retrieved in the aspirate with those retrieved in the flush during transvaginal ultrasound directed oocyte recovery for in vitro fertilization. Br J Obstet Gynaecol 99:841–844PubMedCrossRef

Levens ED, Whitcomb BW, Payson MD, Larsen FW (2009) Ovarian follicular flushing among low-responding patients undergoing assisted reproductive technology. Fertil Steril 91(4 Suppl):1381–1384PubMedCrossRef

Waterstone JJ, Parsons JH (1992) A prospective study to investigate the value of flushing follicles during transvaginal ultrasound directed follicle aspiration. Fertil Steril 57(1):2213

Tan SL, Waterstone J, Wren M, Parsons J (1992) A prospective randomized study comparing aspiration only with aspiration and flushing for transvaginal ultrasound-directed oocyte recovery. Fertil Steril 58(2):356–360PubMed

Knight DC, Tyler JP, Driscoll GL (2001) Follicular flushing at oocyte retrieval: a reappraisal. Aust NZ J Obstet Gynecol 41(2):210–213CrossRef

Scott RT, Hofmann GE, Muasher SJ, Acosta AA, Kreiner DK, Rosenwaks Z (1989) A prospective randomized comparison of single and double-lumen needles for transvaginal follicular aspiration. J In Vitro Fert Embryo Transf 6:98–100PubMedCrossRef

Haydardedeoglu B, Cok T, Kılıcdag EB, Parlakgumus AH, Simsek E, Bagis T (2011) In vitro fertilization-intracytoplasmic sperm injection outcomes in single- versus double-lumen oocyte retrieval needles in normally responding patients: a randomized trial. Fertil Steril 95(2):812–814PubMedCrossRef

Bagtharia S, Haloob AR (2005) Is there a benefit from routine follicular flushing for oocyte retrieval? J Obstet Gynaecol 25:374–376PubMedCrossRef

10.

Kingsland CR, Taylor CT, Aziz N, Bickerton N (1991) Is follicular flushing necessary for oocyte retrieval? A randomized trial. Hum Reprod 6(3):382–383PubMed

Title: Is follicular flushing really effective? A clinical study
Authors: Mustafa Kara
Turgut Aydin
Nurettin Turktekin
Publication date: 01-10-2012
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 4/2012
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-012-2424-1

At a glance: The STEP trials

Springer Medicine

Is follicular flushing really effective? A clinical study

Abstract

Purpose

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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