Effect of Follicular Flushing in Patients With Mono-follicular Growth Undergoing In Vitro Fertilization

Centrum Clinic IVF Center71 enrolled

Overview

Retrieval of an oocyte from a follicle relies on the release of the cumulus-oocyte-complex (COC) from the follicular wall into the lumen, thereby allowing aspiration by a needle. Flushing the follicle with multiple aspirations from the same follicle is used as a means to increase the ratio of COC per aspirated follicle. Data showed that follicular flushing is not superior to direct aspiration either in normally responding patients or in poor responders undergoing in vitro fertilization (IVF). There is no data in the literature regarding the issue in patients with mono-follicular growth. Direct aspiration or repeatedly flushing the follicle for those with a single follicle will be investigated.

Oocyte retrieval procedure This study aims to evaluate the effect of follicular flushing during oocyte retrieval procedure in patients with only one follicle. Double lumen needle will be used and direct follicular aspiration without flushing will be performed for all patients. If an oocyte will be obtained, the patient will be assigned to group A. If not, at least 1 course of follicular flushing will be used until retrieval of an oocyte and the patient will be assigned to group B.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Invitro Fertilization Diminished Ovarian Reserve Oocyte

Interventions

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 40 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * women aged 18-40 years * primary infertility * diminished ovarian reserve with single mature follicle on the day of oocyte retrieval Exclusion Criteria: * natural cycle IVF * presence of endometriosis/endometrioma(s) * Absence of cumulus oocyte complex following oocyte retrieval * Severe male factor infertility * Pre-implantation genetic screening cycles

Outcomes

Primary Outcomes

mature oocyte

Confirmation of cumulus oocyte complex (COC) after microscopic examination of follicular fluid by a senior embryologist for each patient.

Time frame: during oocyte retrieval procedure

Secondary Outcomes

fertilization rate after micro-injection

Confirmation of pronuclei formation on the following day of microinjection by a senior embryologist in each patient.

Time frame: 24 hours after microinjection procedure

clinical pregnancy rate per embryo transfer

Confirmation of fetal cardiac activity on 5th or 6th week of gestation by a senior obstetrician in each pregnancy case.

Time frame: untill 6 weeks