Follicular flushing using double lumen needle yields more oocytes in mono-follicular poor responders.

OBJECTIVE

To compare the efficacy of follicular flushing (FF) with double lumen needle and direct follicular aspiration with single lumen needle in terms of oocyte yield in mono-follicular responder patients undergoing assisted reproduction techniques (ART).

MATERIALS AND

METHODS

Prospective 'quasi-experimental' study was carried out in an IVF center. Infertile women 18-42 years of age with diminished ovarian reserve who revealed a single follicle >17 mm on the day of oocyte retrieval were included in the study. Follicular flushing up to 8 times was performed in FF group using an 17-G double lumen needle. Direct follicular aspiration using a 17-G single lumen needle without FF was performed in direct aspiration group. Total numbers of collected oocytes, metaphase 2 oocytes, fertilization and pregnancy rates were compared among groups.

RESULTS

A total of 206 women underwent oocyte retrieval procedure; 106 women were assigned to FF and 100 women into direct aspiration arm. Overall oocyte retrieval rate was 50.4% in all cases. The total oocyte retrieval rate was higher (65/106, 61.9%) in FF group, than in direct aspiration group (39/100, 39%, p = 0.001). Metaphase 2 oocyte rate was also higher in FF group (47/106, 44.3% vs 29/100, 29% p = 0.04). Fertilization rates, total number of patients with a cleavage stage embryo and grade 1 cleavage embryo were similar among the groups (p>0.5). Numbers of positive hCG, ongoing pregnancy and miscarriage rates were similar among groups.

CONCLUSION

Follicular flushing using double lumen needle in mono-follicular responder patients with diminished ovarian reserve yields more oocytes and mature oocytes than direct aspiration of follicles.