Is follicular flushing really effective? A clinical study

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Abstract
Oocyte retrieval under transvaginal ultrasonographic guidance has been used for in vitro fertilization-intracytoplasmic sperm injection. Despite considerable advances in the assisted reproductive techniques, the efficacy of follicular flushing during egg collection remains controversial. The aim of this study was to compare the follicular aspiration only and aspiration + flushing methods in terms of retrieved oocyte number and clinical pregnancy rates. A total of 200 patients were randomly divided into the intervention and control groups. All the patients underwent long protocol. Oocyte retrieval was performed when the dominant follicle reached 17 mm. Aspiration was performed using a single- or double-lumen catheter. Follicular flushing was performed after follicular aspiration in 100 patients of the intervention group. In the control group, only follicular aspiration was performed. There were no detected differences in the retrieved oocyte number. Although the clinical pregnancy rate in the intervention group was higher than the control group (40 vs. 33 %), the difference was not statistically significant. Cycle cancelation rate was lower in follicular flushing group (8 %) than control group (11 %) but, this difference was not statistically significant. Metaphase I (MI), germinal vesicle numbers were higher in group 1 than in group 2 and the differences were not statistically significant, either. Total operation time was longer in aspiration + flushing group (group 2) than aspiration only group (group 1) and the difference was statistically significant (p = 0.02). In conclusion, our results indicate that follicular flushing during oocyte retrieval does not improve the retrieved oocyte number or clinical pregnancy rate but, it significantly increases the duration of procedure.

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