Document Detail

Follicular flushing during oocyte retrieval in assisted reproductive techniques.
MedLine Citation:
PMID:  20824839     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Ultrasound guided transvaginal aspiration of oocytes has replaced other methods of oocyte retrieval for in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). However, there is controversy over whether flushing yields a larger number of oocytes and a higher potential for pregnancy than aspiration only.
OBJECTIVES: To determine whether follicular aspiration and flushing increases live birth or ongoing pregnancy rates and the number of oocytes over aspiration alone in women undergoing IVF and ICSI.
SEARCH STRATEGY: We searched the Menstrual Disorders and Subfertility Group Specialised Register of controlled trials, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO and the citation lists of relevant publications (to April 2010).
SELECTION CRITERIA: Randomised controlled trials that compared follicular aspiration and flushing with aspiration alone were included. Trials were excluded if the flushing method comparison was confounded by comparisons of other methods.
DATA COLLECTION AND ANALYSIS: Eligible studies were assessed for methodological quality. For dichotomous data, odds ratios (OR) and 95% confidence intervals (CI) were calculated. For continuous data, mean differences were reported. The heterogeneity of the studies was examined by using statistical tests of homogeneity and the I(2) statistic.
MAIN RESULTS: No studies reported on the primary outcome of live birth. There was no evidence (3 studies, 164 patients) to suggest an association between follicular aspiration and flushing and ongoing or clinical pregnancy per woman randomised (OR 1.17, 95% CI 0.57 to 2.38). There was no evidence of a difference in adverse events reported between follicular aspiration and flushing and aspiration only. There was no evidence of significant differences in increased oocyte yield per woman randomised (1 study, 44 patients). Without flushing the operative time was significantly shorter, by 3 to 15 minutes (3 studies, P < 0.001) and the dose of pethidine required was significantly less (50 mg versus 100 mg, P < 0.00001).
AUTHORS' CONCLUSIONS: There is no evidence that follicular aspiration and flushing is associated with improved clinical or ongoing pregnancy rates, nor an increase in oocyte yield. The operative time is significantly longer and more opiate analgesia is required for pain relief during oocyte retrieval. There is a lack of evidence regarding the effect of follicular aspiration and flushing on live birth rates in the identified data.
Supreeya Wongtra-Ngan; Teraporn Vutyavanich; Julie Brown
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2010-09-08
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2010  
Date Detail:
Created Date:  2010-09-08     Completed Date:  2010-10-18     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD004634     Citation Subset:  IM    
Department of Obstetrics & Gynaecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, 50200.
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MeSH Terms
Fertilization in Vitro
Oocyte Retrieval / methods*
Ovarian Follicle*
Pregnancy Rate
Randomized Controlled Trials as Topic
Sperm Injections, Intracytoplasmic
Therapeutic Irrigation
Time Factors

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