All Title Author
Keywords Abstract


Double-Lumen Needle Follicular Flushing System versus Single-Lumen Aspiration Needle in IVF/ICSI Patients with Poor Ovarian Response: A Meta-Analysis

DOI: 10.4236/asm.2017.74014, PP. 167-178

Keywords: Double-Lumen Needle, Single-Lumen Needle, Poor Ovarian Response

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background: The present study performed a meta-analysis to comprehensively analyze existing randomized controlled trials (RCT) involving the use of double-lumen needle in patients with poor ovarian response to explore whether double-lumen needle was good for specific patients. Methods: The PubMed, EMBASE, Cochrane Library databases and two randomized controlled trials registration centers were thoroughly searched until April 2017. The clinical outcomes of IVF/ICSI cycles were compared between two groups with double-lumen needle and single-lumen needle. Results: Four RCT studies were included in this present meta-analysis. The oocytes yield was similar in two groups (OR 0.88, 95%CI 0.66 - 1.16; I2 = 4%). The procedure time with double-lumen needle was significantly longer than that with single-lumen needle (IV = 1.98, 95%CI 0.95 - 3.00; I2 = 86%). The fertilization rate with double-lumen needle was lower than that with single-lumen needle (OR 0.66, 95%CI 0.44 - 0.97; I2 = 0%). There was no significant difference of live birth rate in two groups (OR 0.76, 95%CI 0.32 - 1.76; I2 = 41%). Conclusion: Double-lumen needle could not benefit patients with a POR in terms of the number of oocytes retrieved, oocyte recovery rate, normal fertilization rate, clinical pregnancy rate, and live birth rate, compared with single-lumen needle.

References

[1]  Lenz, S., Lauritsen, J.G. and Kjellow, M. (1981) Collection of Human Oocytes for In Vitro Fertilisation by Ultrasonically Guided Follicular Puncture. Lancet, 1, 1163-1164.
https://doi.org/10.1016/S0140-6736(81)92335-7
[2]  Ludwig, A.K., Glawatz, M., Griesinger, G., Diedrich, K. and Ludwig, M. (2006) Perioperative and Post-Operative Complications of Transvaginal Ultrasound-Guided Oocyte Retrieval: Prospective Study of >1000 Oocyte Retrievals. Human Reproduction, 21, 3235-3240.
https://doi.org/10.1093/humrep/del278
[3]  el Hussein, E., Balen, A.H. and Tan, S.L. (1992) A Prospective Study Comparing the Outcome of Oocytes Retrieved in the Aspirate with Those Retrieved in the Flush during Transvaginal Ultrasound Directed Oocyte Recovery for In-Vitro Fertilization. British Journal of Obstetrics and Gynaecology, 99, 841-844.
https://doi.org/10.1111/j.1471-0528.1992.tb14417.x
[4]  Hill, M.J. and Levens, E.D. (2010) Is There a Benefit in Follicular Flushing in Assisted Reproductive Technology? Current Opinion in Obstetrics and Gynecology, 22, 208-212.
https://doi.org/10.1097/GCO.0b013e3283373bfe
[5]  Levens, E.D., Whitcomb, B.W., Payson, M.D. and Larsen, F.W. (2009) Ovarian Follicular Flushing among Low-Responding Patients Undergoing Assisted Reproductive Technology. Fertility and Sterility, 91, 1381-1384.
https://doi.org/10.1016/j.fertnstert.2008.04.034
[6]  Wongtra-Ngan, S., Vutyavanich, T. and Brown, J. (2010) Follicular Flushing during Oocyte Retrieval in Assisted Reproductive Techniques. The Cochrane Database of Systematic Reviews, CD004634.
[7]  Tan, S.L., Waterstone, J., Wren, M. and Parsons, J. (1992) A Prospective Randomized Study Comparing Aspiration Only with Aspiration and Flushing for Transvaginal Ultrasound-Directed Oocyte Recovery. Fertility and Sterility, 58, 356-360.
https://doi.org/10.1016/S0015-0282(16)55230-3
[8]  Roque, M., Sampaio, M. and Geber, S. (2012) Follicular Flushing during Oocyte Retrieval: A Systematic Review and Meta-Analysis. Journal of Assisted Reproduction and Genetics, 29, 1249-1254.
https://doi.org/10.1007/s10815-012-9869-9
[9]  Levy, G., Hill, M.J., Ramirez, C.I., Correa, L., Ryan, M.E., DeCherney, A.H., et al. (2012) The Use of Follicle Flushing during Oocyte Retrieval in Assisted Reproductive Technologies: A Systematic Review and Meta-Analysis. Human Reproduction, 27, 2373-2379.
https://doi.org/10.1093/humrep/des174
[10]  Zhang, B., Cui, L., Tang, R., Ding, L., Yan, L. and Chen, Z.J. (2017) Reduced Ectopic Pregnancy Rate on Day 5 Embryo Transfer Compared with Day 3: A Meta-Analysis. PLoS One, 12, e0169837.
https://doi.org/10.1371/journal.pone.0169837
[11]  Egger, M., Davey, S.G., Schneider, M. and Minder, C. (1997) Bias in Meta-Analysis Detected by a Simple, Graphical Test. BMJ, 315, 629-634.
https://doi.org/10.1136/bmj.315.7109.629
[12]  Mok-Lin, E., Brauer, A.A., Schattman, G., Zaninovic, N., Rosenwaks, Z. and Spandorfer, S. (2013) Follicular Flushing and in Vitro Fertilization Outcomes in the Poorest Responders: A Randomized Controlled Trial. Human Reproduction, 28, 2990-2995.
https://doi.org/10.1093/humrep/det350
[13]  Haydardedeoglu, B., Gjemalaj, F., Aytac, P.C. and Kilicdag, E.B. (2017) Direct Aspiration versus Follicular Flushing in Poor Responders Undergoing Intracytoplasmic Sperm Injection: A Randomised Controlled Trial. BJOG, 124, 1190-1196.
https://doi.org/10.1111/1471-0528.14629
[14]  Von Horn, K., Depenbusch, M., Schultze-Mosgau, A. and Griesinger, G. (2017) 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. Human Reproduction, 32, 832-835.
https://doi.org/10.1093/humrep/dex019
[15]  Bagtharia, S. and Haloob, A.R. (2005) Is There a Benefit from Routine Follicular Flushing for Oocyte Retrieval? Journal of Obstetrics and Gynaecology, 25, 374-376.
https://doi.org/10.1080/01443610500118970
[16]  Kara, M., Aydin, T. and Turktekin, N. (2012) Is Follicular Flushing Really Effective? A Clinical Study. Archives of Gynecology and Obstetrics, 286, 1061-1064.
https://doi.org/10.1007/s00404-012-2424-1
[17]  Neyens, S., De Neubourg, D., Peeraer, K., De Jaegher, N., Spiessens, C., Debrock, S., et al. (2016) 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. Gynecologic and Obstetric Investigation, 81, 34-40.
https://doi.org/10.1159/000434750
[18]  Mehri, S., Levi Setti, P.E., Greco, K., Sakkas, D., Martinez, G. and Patrizio, P. (2014) Correlation between Follicular Diameters and Flushing versus No Flushing on Oocyte Maturity, Fertilization Rate and Embryo Quality. Journal of Assisted Reproduction and Genetics, 31, 73-77.
https://doi.org/10.1007/s10815-013-0124-9

Full-Text

comments powered by Disqus