Cmco, 19 rue Louis pasteur, 67300, Schiltigheim, France.
Cmco, 19 rue Louis pasteur, 67300, Schiltigheim, France.
Eur J Obstet Gynecol Reprod Biol. 2020 May;248:118-122. doi: 10.1016/j.ejogrb.2020.03.003. Epub 2020 Mar 6.
To compare follicular flushing with a double-lumen needle with direct aspiration on the number of oocytes collected in a poor responder population in IVF.
We conducted a randomized controlled prospective single-center study between March 2011 and June 2016 at the ART center in the Medico-Surgical and Obstetric Center in Schiltigheim, France. Patients undergoing IVF who had ≤ 4 follicles ≥ 14 mm on the day of HCG administration were recruited and then randomized to one of two groups : simple aspiration group (= NO FLUSH) with a single-lumen 17-gauge needle or follicular flushing group (= FLUSH) which underwent oocyte puncture with aspiration and follicular flushing with a double-lumen 17-gauge needle. The primary end-point was the number of oocytes collected. Secondary assessment criteria were the fertilization rate, the number of transferable embryos, the number of clinical pregnancies and their outcome.
252 patients were included: 127 in the Flush group and 125 in the No flush The number of oocytes retrieved per patient was significantly lower in the FLUSH group: 2.41 than in the NO FLUSH group: 3.42 (p < 0.001). The number of transferable embryos, fertilization rate (68.8 % in the FLUSH group versus 75 % p = 0.682), or pregnancy rate weren't different but (15 versus 13). However the number of failed punctures was significantly higher in the FLUSH group (11 % versus 3.2 % p = 0.016) and the duration of oocyte retrieval was significantly longer in the FLUSH group where the median time was 10 min whereas it was only 7 min in the NO FLUSH group, p < 0.001 CONCLUSION: Follicular flushing in poor responders is not beneficial and could be detrimental with an increasing procedure time and less oocytes retrieved.
比较卵泡冲洗与双腔针直接抽吸在体外受精中对卵泡反应不良患者取卵数的影响。
我们在法国施蒂利希姆医疗和妇产科中心的 ART 中心进行了一项 2011 年 3 月至 2016 年 6 月的随机对照前瞻性单中心研究。招募了在 HCG 给药日有≤4 个≥14mm 的卵泡的接受 IVF 的患者，然后将其随机分为两组：单纯抽吸组（=无冲洗）用单腔 17 号针抽吸或卵泡冲洗组（=冲洗）用双腔 17 号针抽吸和卵泡冲洗。主要终点是取卵数。次要评估标准是受精率、可移植胚胎数、临床妊娠数及其结局。
共纳入 252 例患者：冲洗组 127 例，无冲洗组 125 例。冲洗组每位患者的取卵数明显低于无冲洗组：2.41 比 3.42（p<0.001）。可移植胚胎数、受精率（冲洗组 68.8%，无冲洗组 75%，p=0.682）或妊娠率无差异，但（冲洗组 15 例，无冲洗组 13 例）。然而，冲洗组的失败穿刺数明显较高（11%比 3.2%，p=0.016），且取卵时间明显较长，冲洗组中位数为 10 分钟，无冲洗组仅为 7 分钟，p<0.001。
卵泡反应不良患者的卵泡冲洗无益，甚至可能有害，因为它会增加手术时间和减少取卵数。
