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

Abstract

Objective: To compare the efficacy of follicular flushing (FF) with double lumen needle and direct follicularaspiration with single lumen needle in terms of oocyte yield in mono-follicular responder patients undergo ing assisted reproduction techniques (ART).Materials and Methods: Prospective ‘quasi-experimental’ study was carried out in an IVF center. Infertilewomen 18-42 years of age with diminished ovarian reserve who revealed a single follicle >17 mm on theday of oocyte retrieval were included in the study. Follicular flushing up to 8 times was performed in FFgroup using an 17-G double lumen needle. Direct follicular aspiration using a 17-G single lumen needle with out 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 100women into direct aspiration arm. Overall oocyte retrieval rate was 50.4% in all cases. The total oocyte retrievalrate was higher (65/106, 61.9%) in FF group, than in direct aspiration group (39/100, 39%, p = 0.001). Metaphase 2oocyte rate was also higher in FF group (47/106, 44.3% vs 29/100, 29% p = 0.04). Fertilization rates, total number ofpatients 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 dimin ished ovarian reserve yields more oocytes and mature oocytes than direct aspiration of follicles.