Effect of follicle flushing on embryonic developmentoflong protocol controlled ovarian hyperstimulation in vitro fertilization
JING Xia1 FENG Zhonghai2 WEI Bing1 CHEN Bi1 PENG Cailing1 ZOU Lin1 LI Yunqing1 HUANG Riyan1 MA Tianzhong1▲
1.Reproductive Medicine Center, Affiliated Hospital of Guangdong Medical University, Guangdong Province, Zhanjiang 524001, China;
2.Department of Quality Control, Zhanjiang Prevention and Treatment Center for Occupational Diseases, Guangdong Province, Zhanjiang 524001, China
Abstract:Objective To evaluate the effects of follicle flushing on embryonic development in patients of long protocol controlled ovarian hyperstimulation in vitro fertilization. Methods From July 2014 to June 2016, in Reproductive Medicine Center, Affiliated Hospital of Guangdong Medical University, the clinical data of 343 patients underwent in vitro fertilization (IVF) were analyzed retrospectively. Among them,99 patients treated with G-MOPs were set as follicle flushing group, and 244 patients sucked direethy folliculer fluid were as control group. The oocyte retrieval rate, fertilization rate, 2PN cleavage rate, good quality embryo rate, blastocyst rate, available embryo rate, clinical pregnancy rate, implantation rate, abortion rate of two groups were compared. Results The available embryo rate, good quality embryo rate and blastocyst rate in follicle flushing group were higher than those in control group, the differences were statistically significant (P < 0.05), and other clinical and lab indication also checking had no statistical difference between the two groups (P > 0.05). Conclusion Follicle flushing is not necessary to increase the oocyte retrieval rate, but can increase the available embryo rate, good quality embryo rate and blastocyst rate, it showes a increased tendency gradually of clinical pregnancy rate and implantation rate.
[1] Neyens S,De Neubourg D,Peeraer K,et al. Is there a correlation between the number of follicular flushings,oocyte/embryo quality and pregnancy rate in assisted reproductive technology cycles? Results from a prospective study [J]. Gynecol Obstet Invest,2016,81(1):34-40.
[2] 洪青青,周怡雯,匡延平.自然周期取卵术中多次卵泡冲洗的价值[J].生殖医学杂志,2013,22(5):316-319.
[3] Kumaran A,Narayan PK,Pai PJ,et al. Oocyte retrieval at 140-mmHg negative aspiration pressure:a promising alternative to flushing and aspiration in assisted reproduction in women with low ovarian reserve [J]. J Hum Reprod Sci,2015,8(2):98-102.
[4] 陈秀娟,赵杰.颗粒细胞与卵母细胞关系研究进展[J].国际生殖健康/计划生育杂志,2015,34(5):406-409.
[5] Chong YH,Campbell AJ,Farrand S,et al. Anti-Mullerian hormone level in older women: detection of granulosa cell tumor recurrence [J]. Int J Gynecol Cancer,2012,22(9):1497-1499.
[6] Haydardedeoglu B,Cok T,Kilicdag EB,et al. In vitro fertilization-intracytoplasmic sperm injection outcomes in single- versus double-lumen oocyte retrieval needles in normally responding patients:a randomized trial [J]. Fertil Steril,2011,95(2):812-814.
[7] Haydardedeoglu B,Gjemalaj F,Aytac PC,et al. Direct aspiration vs. follicular flushing in poor responders undergoing ICSI: a randomised controlled trial [J]. BJOG,2017,124(8):1190-1196.
[8] Von Horn K,Depenbusch M,Schultze-Mosgau A,et al. Randomized,open trial comparing a modified double-lumen needle follicular flushing system with a single-lumen aspiration needle in IVF patients with poor ovarian response [J]. Hum Reprod,2017,32(4):832-835.
[9] Levy G,Hill MJ,Ramirez CI,et al. The use of follicle flushing during oocyte retrieval in assisted reproductive technologies: a systematic review and meta-analysis [J]. Hum Reprod,2012,27(8):2373-2379.
[10] 郑爱燕,丁洁,顾斌,等.卵泡冲洗对长方案促排卵患者妊娠结局的影响[J].实用医学杂志,2014,30(2):259-261.
[11] Lozano DH,Fanchin R,Chevalier N,et al. Optimising the semi natural cycle IVF:the importance of follicular flushing [J]. J Indian Med Assoc,2006,104(8):423-427.
[12] Von Wolff M,Hua YZ,Santi A,et al. Follicle flushing in monofollicular in vitro fertilization almost doubles the number of transferable embryos [J]. Acta Obstet Gynecol Scand,2013,92(3):346-348.
[13] 陈彩蓉,王秋香,冼英杰.取卵术中卵泡冲洗对IVF-ET的安全性分析[J].中国民族民间医药,2014,23(11):84-87.
[14] 李欣,陈娟,徐鸿毅,等.经阴道穿刺取卵(OPU)术中卵泡冲洗次数与卵母细胞回收情况的分析[J].生殖与避孕,2015,35(8):575-578.
[15] 张翠莲,徐晓航,陈圆辉,等.年轻女性长方案获卵数与临床结局的关系[J].生殖与避孕,2015,35(7):452-457.
[16] 王芳,吴成平.长方案IVF-ET周期获卵数与临床结局的关系分析[J].中国医学创新,2014,11(33):37-40.
[17] 黄品秀,韦继红,韦立红,等.长方案与温和刺激方案在不同获卵数中的临床研究[J].实用妇产科杂志,2016, 32(3):216-220.
[18] 王治鸿,王媛,土增荣,等.废弃胚胎继续囊胚培养和移植的临床结局分析[J].中国临床研究,2016,29(8):1114-1116.
[19] 王雅琴,杨菁,徐望明,等.低等级胚胎囊胚培养及冻融周期移植后临床结局分析[J].生殖医学杂志,2015,24(3):220-224.
[20] Kara M,Aydin T,Turktekin N. Is follicular flushing really effective? a clinical study [J]. Arch Gynecol Obstet,2012, 286(4):1061-1064.