Follicular Flushing Versus Direct Aspiration at Oocyte Retrieval in Poor Responders Undergoing in vitro Fertilization: A Randomized Controlled Trial

AIM: This study aims to study the effect of follicular flushing at oocyte retrieval on Assisted Reproductive Technique (ART) outcomes in poor responders undergoing in vitro fertilization. SETTINGS AND DESIGN: A prospective randomized controlled trial was conducted in the ART center of our hospital. MATERIALS AND METHODS: A total of 71 patients who responded poorly during controlled ovarian stimulation were recruited. Patients were randomized to follicular flushing or to direct aspiration group. The primary outcomes of the study were the total number of oocytes retrieved and the number of metaphase (M II) oocytes retrieved. Secondary outcomes were anesthesia time, procedure time, fertilization rate, cleavage rate, total number of embryos, number of embryos transferred, number of Grade 1 embryos, failed oocyte recovery, failed fertilization, implantation rate, clinical pregnancy rate, miscarriage rate, and live birth rate. STATISTICAL ANALYSIS USED: Chi-square test and Student's t-test. RESULTS: The total number of oocytes retrieved, number of M II oocytes, fertilization rate, cleavage rate, total number of embryos, number of Grade 1 embryos, failed oocyte recovery, failed fertilization, implantation rate, miscarriage rate, and live birth rate were comparable between the two groups. The anesthesia and procedure time was significantly higher in the flushing group. CONCLUSIONS: Follicular flushing does not result in a significant improvement in the ART outcomes despite increasing procedure and anesthesia times. Trial registration number CTRI/2017/07/009062.