Skip to main content
SpringerLink
Log in

A Monocentric Randomized Controlled Clinical Trial to Compare Single- and Double-Lumen Needles in Oocyte Retrieval Procedure in Assisted Reproductive Technologies

  • Infertility: Clinical Trials
  • Published:
Reproductive Sciences Aims and scope Submit manuscript

Abstract

The purpose was to determine any difference in outcomes, primarily in terms of number of retrieved oocytes per procedure, between two different needles used for oocytes retrieval procedure in Assisted Reproductive Technologies: the single-lumen needle (SLN) versus the double-lumen needle (DLN) with follicle flushing after aspiration. This randomized controlled trial included oocyte retrieval (OR) cycles for IVF and ICSI performed in 18 to 42-year-old women between March 2019 and January 2021 at a tertiary-care Fertility Center. A total of 200 ORs were randomized, 100 in each group. The mean number of retrieved oocytes was not different between groups (10.2 ± 6.5 for DLNs vs. 10.7 ± 7.0 for SLNs, p = 0.810). No significant differences were observed also in terms of number of retrieved oocytes/punctured follicles (83.0% ± 27.0% vs. 81.0% ± 22.0%, p = 0.916), number of retrieved oocytes/follicles at trigger (78.0% ± 29.0% vs. 78.0% ± 27.0%, p = 0.881), number of mature oocytes (7.6 ± 5.3 vs. 8.0 ± 5.1, p = 0.519), and pregnancy rate (27% vs. 23%, p = 0.514). However, the time required to retrieve each oocyte was longer using the DLN (1.5 ± 1.3 vs. 1.1 ± 0.9 minutes, p = 0.002). The present study confirmed the new perspectives on the sole use of SLNs in terms of saving time, without affecting the number of retrieved oocytes. Trial registration number and date of registration NCT03611907; July 26, 2018.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data Availability

Datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Code Availability

Dataset underlying this article is available in Zenodo repository and can be accessed, upon reasonable request to the corresponding author, since it includes sensitive data.

References

  1. Wongtra-Ngan S, Vutyavanich T, Brown J. Follicular flushing during oocyte retrieval in assisted reproductive techniques. Cochrane Database Syst Rev. 2010;9:CD004634. https://doi.org/10.1002/14651858.CD004634.pub2.

    Article  Google Scholar 

  2. Bagtharia S, Haloob AR. Is there a benefit from routine follicular flushing for oocyte retrieval? J Obstet Gynaecol. 2005;25(4):374–6. https://doi.org/10.1080/01443610500118970.

    Article  CAS  PubMed  Google Scholar 

  3. Levens ED, Whitcomb BW, Payson MD, Larsen FW. Ovarian follicular flushing among low-responding patients undergoing assisted reproductive technology. Fertil Steril. 2009;91(4 Suppl):1381–4. https://doi.org/10.1016/j.fertnstert.2008.04.034.

    Article  CAS  PubMed  Google Scholar 

  4. Haydardedeoglu B, Cok T, Kilicdag EB, Parlakgumus AH, Simsek E, Bagis T. In vitro fertilization-intracytoplasmic sperm injection outcomes in single- versus double-lumen oocyte retrieval needles in normally responding patients: a randomized trial. Fertil Steril. 2011;95(2):812–4. https://doi.org/10.1016/j.fertnstert.2010.09.013.

    Article  PubMed  Google Scholar 

  5. Scoccia H. In vitro fertilization oocyte retrieval: to "flush" or not? Fertil Steril. 2021;115(4):891. https://doi.org/10.1016/j.fertnstert.2021.01.033.

    Article  PubMed  Google Scholar 

  6. Martini AE, Dunn A, Wells L, Rollene N, Saunders R, Healy MW, et al. Follicle flushing does not improve live birth and increases procedure time: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril. 2021;115(4):974–83. https://doi.org/10.1016/j.fertnstert.2020.10.064.

    Article  PubMed  Google Scholar 

  7. Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A. Association between the number of eggs and live birth in IVF treatment: an analysis of 400 135 treatment cycles. Hum Reprod. 2011;26(7):1768–74. https://doi.org/10.1093/humrep/der106.

    Article  PubMed  Google Scholar 

  8. Oudendijk JF, Yarde F, Eijkemans MJ, Broekmans FJ, Broer SL. The poor responder in IVF: is the prognosis always poor?: a systematic review. Hum Reprod Update. 2012;18(1):1–11. https://doi.org/10.1093/humupd/dmr037.

    Article  CAS  PubMed  Google Scholar 

  9. Hill MJ, Levens ED. Is there a benefit in follicular flushing in assisted reproductive technology? Curr Opin Obstet Gynecol. 2010;22(3):208–12. https://doi.org/10.1097/GCO.0b013e3283373bfe.

    Article  PubMed  Google Scholar 

  10. D'Angelo A, Panayotidis C, Amso N, Marci R, Matorras R, Onofriescu M, et al. Recommendations for good practice in ultrasound: oocyte pick up. Hum Reprod Open. 2019;2019(4):hoz025. https://doi.org/10.1093/hropen/hoz025.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, et al. The international glossary on infertility and fertility care, 2017. Fertil Steril. 2017;108(3):393–406. https://doi.org/10.1016/j.fertnstert.2017.06.005.

    Article  PubMed  Google Scholar 

  12. Esteves SC, Roque M, Bedoschi GM, Conforti A, Humaidan P, Alviggi C. Defining low prognosis patients undergoing assisted reproductive technology: POSEIDON criteria-the why. Front Endocrinol (Lausanne). 2018;9:461. https://doi.org/10.3389/fendo.2018.00461.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Knight DC, Tyler JP, Driscoll GL. Follicular flushing at oocyte retrieval: a reappraisal. Aust N Z J Obstet Gynaecol. 2001;41(2):210–3.

    Article  CAS  PubMed  Google Scholar 

  14. Lozano DH, Fanchin R, Chevalier N, Feyereisen E, Hesters L, Frydman N, et al. Optimising the semi natural cycle IVF: the importance of follicular flushing. J Indian Med Assoc. 2006;104(8):423–7.

    PubMed  Google Scholar 

  15. Levy G, Hill MJ, Ramirez CI, Correa L, Ryan ME, DeCherney AH, et al. The use of follicle flushing during oocyte retrieval in assisted reproductive technologies: a systematic review and meta-analysis. Hum Reprod. 2012;27(8):2373–9. https://doi.org/10.1093/humrep/des174.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Levy G, Hill MJ, Ramirez C, Plowden T, Pilgrim J, Howard RS, et al. Serum human chorionic gonadotropin levels on the day before oocyte retrieval do not correlate with oocyte maturity. Fertil Steril. 2013;99(6):1610–4. https://doi.org/10.1016/j.fertnstert.2012.12.053.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Levi-Setti PE, Cirillo F, Scolaro V, Morenghi E, Heilbron F, Girardello D, et al. Appraisal of clinical complications after 23,827 oocyte retrievals in a large assisted reproductive technology program. Fertil Steril. 2018;109(6):1038–43.e1. https://doi.org/10.1016/j.fertnstert.2018.02.002.

    Article  PubMed  Google Scholar 

  18. Esteves SC, Roque M, Sunkara SK, Conforti A, Ubaldi FM, Humaidan P, et al. Oocyte quantity, as well as oocyte quality, plays a significant role for the cumulative live birth rate of a POSEIDON criteria patient. Hum Reprod. 2019;34(12):2555–7.

    Article  PubMed  Google Scholar 

  19. Esteves SC, Alviggi C, Humaidan P, Fischer R, Andersen CY, Conforti A, et al. The POSEIDON criteria and its measure of success through the eyes of clinicians and embryologists. Front Endocrinol (Lausanne). 2019;10:814. https://doi.org/10.1093/humrep/dez181.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Levi-Setti PE, Zerbetto I, Baggiani A, Zannoni E, Sacchi L, Smeraldi A, et al. An observational retrospective cohort trial on 4,828 IVF cycles evaluating different low prognosis patients following the POSEIDON criteria. Front Endocrinol (Lausanne). 2019;10:282. https://doi.org/10.3389/fendo.2019.00282.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Humaidan P, Alviggi C, Fischer R, Esteves SC. The novel POSEIDON stratification of 'low prognosis patients in assisted reproductive technology' and its proposed marker of successful outcome. F1000Res. 2016;5:2911. https://doi.org/10.12688/f1000research.10382.1.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors thank all the embryologists and gynecologists working at Humanitas Fertility Center, Rozzano, Milan, Italy.

Author information

Authors and Affiliations

  1. IRCCS Humanitas Research Hospital, Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Centre, Rozzano, via Manzoni 56, 20089, Milan, Italy

    Camilla Ronchetti, Federico Cirillo, Valentina Immediata, Clara Gargasole, Valeria Scolaro, Elena Albani & Paolo Emanuele Levi-Setti

  2. Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, via Rita Levi Montalcini 4, 20090, Milan, Italy

    Camilla Ronchetti, Federico Cirillo, Valentina Immediata, Emanuela Morenghi & Paolo Emanuele Levi-Setti

  3. IRCCS Humanitas Research Hospital, Biostatistics Unit, Rozzano, via Manzoni 56, 20089, Milan, Italy

    Emanuela Morenghi

  4. University of Miami, Miller School of Medicine, Division Reproductive Endocrinology and Infertility, Miami, FL, USA

    Pasquale Patrizio

Authors
  1. Camilla Ronchetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Federico Cirillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Valentina Immediata
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Clara Gargasole
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Valeria Scolaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Emanuela Morenghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Elena Albani
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Pasquale Patrizio
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Paolo Emanuele Levi-Setti
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Camilla Ronchetti, Federico Cirillo, and Paolo Emanuele Levi-Setti were involved in the study concept and design. Valentina Immediata, Clara Gargasole, Valeria Scolaro, and Emanuela Morenghi contributed to the acquisition of data. Federico Cirillo, Camilla Ronchetti, and Emanuela Morenghi analyzed data. Federico Cirillo, Camilla Ronchetti, and Paolo Emanuele Levi-Setti wrote the manuscript and had a primary responsibility for final content. Emanuela Morenghi and Paolo Emanuele Levi-Setti supervised the analysis. Camilla Ronchetti contributed to bibliography updating. Pasquale Patrizio and Elena Albani critically revised the manuscript and helped for data analysis. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Paolo Emanuele Levi-Setti.

Ethics declarations

Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional Humanitas research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of Humanitas institutional review board on January 23rd, 2018.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

Participants have consented to the submission of the study results for publication.

Competing Interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ronchetti, C., Cirillo, F., Immediata, V. et al. A Monocentric Randomized Controlled Clinical Trial to Compare Single- and Double-Lumen Needles in Oocyte Retrieval Procedure in Assisted Reproductive Technologies. Reprod. Sci. 30, 2866–2875 (2023). https://doi.org/10.1007/s43032-023-01232-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43032-023-01232-w

Keywords

Search

Navigation