title: Correlation between follicular diameters and flushing versus no flushing on oocyte maturity, fertilization rate and embryo quality.
abstract: OBJECTIVE
  To determine (a) the correlation between follicular sizes, oocyte maturity, normal fertilization rate, cleavage and embryo quality; and (b) to establish whether oocytes recovered with or without follicular flushing have different developmental competence.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Forty nine cycles (37 ICSI and 12 IVF).
  
  
  METHODS
  Measurement of 360 follicular diameters on the day of egg retrieval and classification into three groups Group A (mean diameter 12-14.5 mm.), group B (mean diameter 15-18 mm.) and group C (diameter >18.5 mm.).
  
  
  METHODS
  Correlation between follicular size at the time of retrieval and oocyte maturity, fertilization and cleavage rate in 226 oocytes (163 ICSI and 63 IVF). Developmental competence of oocytes retrieved with flushing versus non flushing.
  
  
  RESULTS
  Almost all (99 %) of the oocytes recovered from follicles of group C were in metaphase II as opposed to 80 % in group A and 81 % in group B (p < 0.01). Overall there was a progressive and significant increase in fertilization rates from group A follicles to group C (47 % vs. 67 %, p 0.05). Overall 53 % of oocytes retrieved from group A follicles showed either no fertilization or abnormal fertilization versus 27 % in group C (p 0.05). The oocyte recovery rate with follicular flushing improved from group A to group B and to group C follicles (65 % vs. 49 % vs.37 % respectively p < 0.01). There were no differences in rates of immature oocyte, fertilization, abnormal or not fertilization and cleavage.
  
  
  CONCLUSIONS
  The results of this study shows that: a) Follicles larger than 18 mm at retrieval have consistently mature oocytes with a higher rate of fertilization; b) Small size follicles are still capable of containing mature oocytes, but their rate of abnormal or no fertilization is high; c) Oocytes recovered with flushing are still able to produce embryos with full developmental competence.
authors.affiliation: Yale University Medical School-Yale Fertility Center, New Haven, CT, USA.
authors.forename: S
authors.initials: S
authors.lastname: Mehri
authors.forename: P E
authors.initials: PE
authors.lastname: Levi Setti
authors.forename: K
authors.initials: K
authors.lastname: Greco
authors.forename: D
authors.initials: D
authors.lastname: Sakkas
authors.forename: G
authors.initials: G
authors.lastname: Martinez
authors.forename: P
authors.initials: P
authors.lastname: Patrizio
mesh_terms: D048429:Cell Size; D004624:Embryo Transfer / Q000706:statistics & numerical data; D004622:Embryo, Mammalian / Q000166:cytology*; D047108:Embryonic Development; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data; D006801:Humans; D054315:Oocyte Retrieval / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D009866:Oogenesis; D006080:Ovarian Follicle / Q000166:cytology*; D011247:Pregnancy; D018873:Pregnancy Rate; D011786:Quality Control