Tan S L, Waterstone J, Wren M, Parsons J
Department of Obstetrics and Gynaecology, King's College School of Medicine and Dentistry, London, United Kingdom.
Fertil Steril. 1992 Aug;58(2):356-60. doi: 10.1016/s0015-0282(16)55230-3.
To compare aspiration only with aspiration and flushing of ovarian follicles during transvaginal ultrasound (US)-directed oocyte recovery.
Prospective randomized study.
One hundred patients who were undergoing an in vitro fertilization (IVF) treatment cycle.
All patients underwent pituitary desensitization before the administration of gonadotropins. Monitoring of ovarian stimulation and the criteria for the administration of human chorionic gonadotropin were similar in both groups. In patients in whom aspiration alone was used, each follicle was aspirated until it was empty. The US probe was then rotated until every drop of follicular fluid had been aspirated before the next follicle was aspirated and the procedure repeated. For patients who had aspiration and flushing, each follicle was aspirated and then flushed up to a maximum of six times before moving to the next follicle. In both groups, all follicles greater than 10 mm were aspirated.
The indication for IVF and mean age of the patients were comparable in the two groups. There were no significant differences between the aspiration and the aspiration and flushing groups in terms of the number of oocytes retrieved (11 versus 9), the oocyte recovery rates (77.5% versus 77.0%), the fertilization rates (55.6% versus 60.0%), the number of embryos transferred (2 versus 2), or the number of clinical pregnancies (12 versus 13). The time taken for oocyte recovery was significantly shorter (15 versus 30 minutes, P less than 0.00001), and the dose of pethidine required significantly less (50 mg versus 100 mg, P less than 0.00001) in the aspiration only group.
Aspiration alone produces comparable oocyte recovery rates as aspiration and flushing while significantly reducing the length of the procedure and the dose of analgesia required. Aspiration alone suffices for virtually all cases during transvaginal US-directed oocyte recovery.
比较经阴道超声引导下卵母细胞采集过程中单纯抽吸与抽吸加冲洗卵巢卵泡的效果。
前瞻性随机研究。
100例行体外受精（IVF）治疗周期的患者。
所有患者在使用促性腺激素前均接受垂体脱敏。两组在卵巢刺激监测及人绒毛膜促性腺激素给药标准方面相似。对于仅采用抽吸的患者，每个卵泡均抽吸至空。然后旋转超声探头，直至在下一个卵泡抽吸前已抽吸尽每一滴卵泡液，该过程重复进行。对于采用抽吸加冲洗的患者，每个卵泡先抽吸，然后冲洗最多6次，再处理下一个卵泡。两组中，所有直径大于10mm的卵泡均被抽吸。
两组患者的IVF指征及平均年龄相当。在获取的卵母细胞数量（11个对9个）、卵母细胞回收率（77.5%对77.0%）、受精率（55.6%对60.0%）、移植胚胎数量（2个对2个）或临床妊娠数量（12例对13例）方面，单纯抽吸组与抽吸加冲洗组之间无显著差异。单纯抽吸组的卵母细胞采集时间显著更短（15分钟对30分钟，P<0.00001），所需哌替啶剂量显著更少（50mg对100mg，P<0.00001）。
单纯抽吸与抽吸加冲洗的卵母细胞回收率相当，同时显著缩短了操作时间并减少了所需镇痛剂量。在经阴道超声引导下卵母细胞采集过程中，几乎所有情况单纯抽吸就足够了。
