Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA.
Curr Opin Obstet Gynecol. 2010 Jun;22(3):208-12. doi: 10.1097/GCO.0b013e3283373bfe.
Follicular flushing utilizing double-lumen retrieval needles attempts to increase oocyte yield during transvaginal retrieval. The original work on this topic, now more than 2 decades old, examined its utility in normal-responding assisted reproductive technologies (ART) patients. Newer studies examining its utility have focused on special populations expected to demonstrate benefit: poor responders, natural cycle and minimal stimulation ART, and in-vitro maturation cycles. This review assesses the current evidence regarding the effectiveness of ovarian follicular flushing in improving oocyte yield.
Follicular flushing offers no substantive benefit in oocyte yield, fertilization rates, or pregnancy outcomes for normal and poor-responding ART patients. Patients undergoing natural cycle or minimal stimulation ART may benefit from follicular flushing resulting in more mature embryos but unclear effects on cycle outcome.
Randomized controlled trials consistently demonstrate no benefit and increased procedural time with follicular flushing in both normal and poor-responding ART patients. Nonrandomized data suggest a possible role for follicular flushing in natural cycle or minimal stimulation ART and in those undergoing in-vitro maturation IVF cycles; however, randomized controlled trials are needed to verify this finding. Presently, there is insufficient evidence to recommend the routine use of follicular flushing.
利用双腔取卵针进行卵泡冲洗，旨在增加经阴道取卵时的卵子产量。这一主题最初的研究可追溯到 20 多年前，主要集中在正常反应辅助生殖技术（ART）患者中研究其效用。最近的研究集中在预计会受益的特殊人群上：反应不良者、自然周期和微刺激 ART 以及体外成熟周期。本综述评估了目前关于卵巢卵泡冲洗在提高卵子产量方面有效性的证据。
卵泡冲洗在提高卵子产量、受精率或妊娠结局方面，对正常和反应不良的 ART 患者均无实质性益处。接受自然周期或微刺激 ART 的患者可能受益于卵泡冲洗，从而获得更多成熟的胚胎，但对周期结局的影响尚不清楚。
随机对照试验一致表明，卵泡冲洗在正常和反应不良的 ART 患者中均无益，且增加了手术时间。非随机数据表明，卵泡冲洗可能对自然周期或微刺激 ART 以及体外成熟 IVF 周期有一定作用；然而，需要进行随机对照试验来验证这一发现。目前，尚无足够的证据推荐常规使用卵泡冲洗。
