title: Direct aspiration versus follicular flushing in poor responders undergoing intracytoplasmic sperm injection: a randomised controlled trial.
abstract: OBJECTIVE
  To compare follicle flushing three times with direct follicular aspiration in poor responders. Our hypothesis was that follicle flushing three times in poor responders would result in similar oocyte yield compared with direct aspiration in poor responders.
  
  
  METHODS
  A randomised controlled trial performed between January 2015 and June 2015.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Eighty eligible poor responders, who were defined as having five or fewer follicles ≥13 mm in average diameter with at least two follicles having maximum diameters >17 mm on the day of human chorionic gonadotrophin administration. Monofollicular cycles, including natural cycles, were excluded from the current trial.
  
  
  METHODS
  In the double-lumen needle group, oocyte retrieval was performed by flushing three times with 2 ml in each follicle and in the single-lumen group direct follicle aspiration was performed.
  
  
  METHODS
  Number of metaphase II oocytes retrieved.
  
  
  RESULTS
  The mean number of metaphase II oocytes was similar in both groups (1.9 ± 0.1 versus 2.1 ± 0.1, respectively). The clinical pregnancy and live birth rates were similar in both groups (32.5% versus 25% and 25% versus 22.5%, respectively). The only significant difference between the two groups was the duration of oocyte retrieval (178.4 ± 13.4 versus 236.3 ± 24.1 seconds, respectively, P = 0.01).
  
  
  CONCLUSIONS
  Follicular flushing is time consuming and has similar results compared with direct follicle aspiration in poor responders.
  
  
  CONCLUSIONS
  Direct follicle aspiration versus flushing in poor responders yields similar metaphase II oocytes.
authors.affiliation: Division of Reproductive Endocrinology and IVF Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, Baskent University, Adana, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Haydardedeoglu
authors.affiliation: Division of Reproductive Endocrinology and IVF Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, Baskent University, Adana, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Gjemalaj
authors.affiliation: Division of Reproductive Endocrinology and IVF Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, Baskent University, Adana, Turkey.
authors.forename: P C
authors.initials: PC
authors.lastname: Aytac
authors.affiliation: Division of Reproductive Endocrinology and IVF Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, Baskent University, Adana, Turkey.
authors.forename: E B
authors.initials: EB
authors.lastname: Kilicdag
mesh_terms: D000328:Adult; D004624:Embryo Transfer / Q000379:methods; D005260:Female; D006801:Humans; D054315:Oocyte Retrieval / Q000379:methods*; D006080:Ovarian Follicle; D010062:Ovulation Induction / Q000379:methods; D019152:Paracentesis / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D007507:Therapeutic Irrigation / Q000379:methods*; D016896:Treatment Outcome
keywords: follicular flushing; in vitro fertilisation/ intracytoplasmic sperm injection; live birth rate; metaphase II oocyte; poor responders