Fertipraxis, Human Reproduction Center, Rio de Janeiro, Brazil.
JBRA Assist Reprod. 2021 Apr 27;25(2):272-275. doi: 10.5935/1518-0557.20210009.
The purpose of this study was to investigate the possible impact of follicular flushing on the number of oocytes retrieved and oocytes in metaphase II in patients with poor ovarian response (POR) compared to direct aspiration.
This prospective, comparative, randomized single center study included 208 punctures of patients with POR, submitted to assisted reproduction technology (ART) treatments. Two groups were compared; one in which double lumen needles were used (Wallace DNS1733) for follicular flushing (n=105), and one in which single lumen needles were used (Wallace ONS1733) for direct aspiration (n=103), upon the observation of ≤ 5 follicles between 15-17 mm, ≤ 4 follicles with sizes greater than 18 mm on hCG day, and ≤ 7 recovered oocytes.
There were no differences in age (39.07±3.88 vs. 38.11±3.43); weight (61.73±17.53 vs. 65.96±15.44); AMH (0.63±0.59 vs. 0.94±0.97); stimulation days (9.57±1.87 vs. 10.29±2.82); estradiol levels (788.94±670.82 vs. 940.16±694.69); progesterone (617.29±319.76 vs. 561.18±486.78); or number of follicles with sizes ≥18 mm (1.84±0.95 vs. 2.07±1.09). Although gonadotropin totals (1678.28±798.52 vs. 2080.45±852.36; p=0.0008), number of aspirated oocytes (3.00±2.11 vs. 3.69±2.20; p=0.02), and number of metaphase II oocytes (2.20±1.64 vs. 2.99±1.88; p=0.02) were significantly different, oocyte / follicle ratio ≥15 mm (0.93 vs. 0.98) and metaphase II oocytes / follicles ≥15 mm (0.68 vs. 0.79) were similar in both groups. The failure to capture was 16% vs. 9.8%.
Considering that there was no difference in the oocyte per follicle ratio, follicular flushing did not increase the number of oocytes recovered from poor responders.
本研究旨在探讨卵泡冲洗对卵巢反应不良（POR）患者与直接抽吸相比获得的卵母细胞数量和中期 II 卵母细胞的可能影响。
这项前瞻性、比较性、随机单中心研究纳入了 208 例 POR 患者的穿刺，他们接受了辅助生殖技术（ART）治疗。比较了两组：一组使用双腔针（Wallace DNS1733）进行卵泡冲洗（n=105），另一组使用单腔针（Wallace ONS1733）进行直接抽吸（n=103），在 hCG 日观察到≤15-17mm 的 5 个卵泡，≤4 个大小大于 18mm 的卵泡，≤7 个回收卵母细胞。
两组在年龄（39.07±3.88 vs. 38.11±3.43）、体重（61.73±17.53 vs. 65.96±15.44）、AMH（0.63±0.59 vs. 0.94±0.97）、刺激天数（9.57±1.87 vs. 10.29±2.82）、雌二醇水平（788.94±670.82 vs. 940.16±694.69）、孕酮（617.29±319.76 vs. 561.18±486.78）或≥18mm 的卵泡数量（1.84±0.95 vs. 2.07±1.09）方面均无差异。虽然促性腺激素总量（1678.28±798.52 vs. 2080.45±852.36；p=0.0008）、抽吸的卵母细胞数量（3.00±2.11 vs. 3.69±2.20；p=0.02）和中期 II 卵母细胞数量（2.20±1.64 vs. 2.99±1.88；p=0.02）存在显著差异，但≥15mm 的卵母细胞/卵泡比率（0.93 vs. 0.98）和≥15mm 的中期 II 卵母细胞/卵泡比率（0.68 vs. 0.79）在两组之间相似。未能捕获的比例为 16% vs. 9.8%。
考虑到卵泡冲洗对卵母细胞/卵泡比率没有影响，因此它并没有增加卵巢反应不良患者回收的卵母细胞数量。
