title: Oocyte retrieval at 140-mmHg negative aspiration pressure: A promising alternative to flushing and aspiration in assisted reproduction in women with low ovarian reserve.
abstract: BACKGROUND
  Oocyte retrieval in women with low ovarian reserve is challenging and often results in poor pregnancy outcomes.
  
  
  OBJECTIVE
  The aim was to compare outcomes of oocyte retrieval using three aspiration methods in women with normal and low antral follicle counts (AFCs).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Tertiary care hospital.
  
  
  METHODS
  Data from 172 women who underwent in-vitro fertilization/intracytoplasmic sperm injection over 3 years was studied after dividing into three groups: Group A (96) - normal AFC (≥10), direct oocyte retrieval at 120 mmHg, Group B (41) - low AFC (<10), direct retrieval at 140-mmHg, Group C (35) - low AFC, follicular flushing, and aspiration at 120-mmHg. In each group, oocyte yield, embryo quality, and pregnancy out comes were assessed.
  
  
  RESULTS
  The oocyte and embryo yield in Groups A and B were comparable (P > 0.05) but were significantly less in Group C (P < 0.05). The pregnancy rates in Groups A and B were similar (35.4%, 39%) but were significantly less (17.1%) in Group C (P < 0.05). The live birth rate was 76% in Group A, 69% in Group B, and 50% in Group C. The miscarriage rates in the three groups were 21%, 31%, and 50%, respectively.
  
  
  CONCLUSIONS
  Direct oocyte retrieval with 140-mmHg showed significantly better oocyte yield and pregnancy outcomes compared to flushing and aspiration in women with low AFC.
authors.affiliation: Department of OBG, Kasturba Medical College, Manipal, Karnataka, India.
authors.forename: Aswathy
authors.initials: A
authors.lastname: Kumaran
authors.affiliation: Department of OBG, Kasturba Medical College, Manipal, Karnataka, India.
authors.forename: Pratap Kumar
authors.initials: PK
authors.lastname: Narayan
authors.affiliation: Department of OBG, Kasturba Medical College, Manipal, Karnataka, India.
authors.forename: Praveena Joglekar
authors.initials: PJ
authors.lastname: Pai
authors.affiliation: Department of OBG, Kasturba Medical College, Manipal, Karnataka, India.
authors.forename: Amar
authors.initials: A
authors.lastname: Ramachandran
authors.affiliation: Department of OBG, Kasturba Medical College, Manipal, Karnataka, India.
authors.forename: Basil
authors.initials: B
authors.lastname: Mathews
authors.affiliation: Department of Clinical Embryology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Satish Kumar
authors.initials: SK
authors.lastname: Adiga
keywords: Flushing and aspiration; oocyte aspiration; vacuum aspiration pressure