El-Goly Nour A, Maged Ahmed M, Essam Aimy, Shoab Amira
Faculty of medicine, Cairo University, Cairo, Egypt.
Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
Contracept Reprod Med. 2025 Mar 31;10(1):25. doi: 10.1186/s40834-025-00351-w.
To assess the value of follicular flushing during ovum pick up compared to follicular aspiration in IVF cycles.
Screening of PubMed, Web Of Science, Cochrane, Scopus, and clinical trials registry from inception to October 2024. The search key words included follicular flushing, follicle aspiration, ovum pick up, oocyte retrieval, IVF, and their MeSH terms.
This review included all RCTs that evaluated the use of follicular flushing during ovum pick-up. Seventeen studies including 2218 participants (1124 were subjected to follicular flushing and 1094 subjected to follicular aspiration) were included.
The extracted data included the settings of the study, the number and characteristics of participants, intervention details including the number of flushes, and the suction pressure used, outcome parameters including number of retrieved oocytes, the oocyte/ follicle ratio, the number of MII oocytes, the time of the procedure, the fertilization, implantation, clinical pregnancy, chemical pregnancy, ongoing pregnancy, live birth, miscarriage and cancellation rates, and risk of bias assessment.
The number of retrieved and MII oocytes were evaluated in 14 and 11 studies with 1920 and 1588 participants and revealed a mean difference (MD) of 0.03 and 0.16 with [-0.50, 0.57] and [-0.29, 0.61] 95% CI (P value =0.9 and 0.48, I = 87% and 90%), respectively. The fertilization and implantation rates were evaluated in 4 and 7 studies with 3331 and 1605 participants and revealed an Odd Ratio (OR) of 1.48 and 0.91 with [0.98, 2.24] and [0.55, 1.51] 95% CI (P value =0.06 and 0.72, I = 82% and 61%), respectively. The clinical pregnancy rate was evaluated in 11 studies with 1542 participants and revealed an Odd Ratio (OR) of 1.23 with [0.86, 1.74] 95% CI (P value =0.26, I = 42%). The ongoing pregnancy /livebirth rate was evaluated in 11 studies with 1266 participants and revealed an Odd Ratio (OR) of 1.07 with [0.80, 1.43] 95% CI (P value =0.65, I = 0%). The time of the procedure was evaluated in 8 studies with 985 participants and revealed a mean difference (MD) of 178.58 with [98.23, 258.93] 95% CI (P value <0.001, I = 97%). The cycle cancellation rate was evaluated in 5 studies with 856 participants and revealed an Odd Ratio (OR) of 0.66 with [0.45, 0.98] 95% CI (P value =0.04, I = 0%).
Follicular flushing during oocyte retrieval did not improve the number of retrieved oocytes, the oocyte retrieved over the aspirated follicles ration, the number of MII oocytes, the fertilization rate, implantation rate, clinical pregnancy, chemical pregnancy, ongoing pregnancy/livebirth, and miscarriage rates and associated with significant prolongation of the procedure. Cycle cancellation was significantly improved with follicular flushing in women with poor ovarian response.
Registration number CRD42024600698 date of registration 23/10/2024.
评估在体外受精（IVF）周期中，与卵泡抽吸相比，取卵时卵泡冲洗的价值。
检索自起始至2024年10月的PubMed、科学网、考克兰图书馆、Scopus以及临床试验注册库。检索关键词包括卵泡冲洗、卵泡抽吸、取卵、卵母细胞采集、体外受精及其医学主题词。
本综述纳入了所有评估取卵时使用卵泡冲洗的随机对照试验（RCT）。共纳入17项研究，包括2218名参与者（1124名接受卵泡冲洗，1094名接受卵泡抽吸）。
提取的数据包括研究背景、参与者数量及特征、干预细节（包括冲洗次数和使用的抽吸压力）、结局参数（包括回收的卵母细胞数量、卵母细胞/卵泡比率、MII期卵母细胞数量、手术时间、受精率、着床率、临床妊娠率、化学妊娠率、持续妊娠率、活产率、流产率和取消率）以及偏倚风险评估。
在14项研究（1920名参与者）和11项研究（1588名参与者）中分别评估了回收的卵母细胞数量和MII期卵母细胞数量，平均差异（MD）分别为0.03和0.16，95%置信区间（CI）分别为[-0.50, 0.57]和[-0.29, 0.61]（P值=0.9和0.48，I²=87%和90%）。在4项研究（3331名参与者）和7项研究（1605名参与者）中分别评估了受精率和着床率，优势比（OR）分别为1.48和0.91，95%CI分别为[0.98, 2.24]和[0.55, 1.51]（P值=0.06和0.72，I²=82%和61%）。在11项研究（1542名参与者）中评估了临床妊娠率，优势比（OR）为1.23，95%CI为[0.86, 1.74]（P值=0.26，I²=42%）。在11项研究（1266名参与者）中评估了持续妊娠/活产率，优势比（OR）为1.07，95%CI为[0.80, 1.43]（P值=0.65，I²=0%）。在8项研究（985名参与者）中评估了手术时间，平均差异（MD）为178.58，95%CI为[98.23, 258.93]（P值<0.001，I²=97%）。在5项研究（856名参与者）中评估了周期取消率，优势比（OR）为
