ISSN: 2148-8274 / E-ISSN: 2587-0084
, Türk Üreme Tıbbı ve Cerrahisi
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Turkish Journal of Reproductive Medicine and Surgery

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ORİJİNAL ARAŞTIRMALAR

Yumurta Toplama İşlemi Sırasında Foliküllerin Yıkanması Düşük Over Rezervli Hastalarda Gebelik Şansını Etkiler, Ancak Canlı Doğum Oranlarını Etkilemez
Flushing of the Follicles in Ovum Pick-Up Procedures Impacts the Chance for Pregnancy, But Not Birth Rates in Low Ovarian Reserve Patients
Received Date : 21 Mar 2023
Accepted Date : 29 Aug 2023
Available Online : 31 Aug 2023
Doi: 10.24074/tjrms.2023-96832 - Makale Dili: EN
TJRMS. 2023;7(3):94-100
ÖZET
Amaç: Bu çalışma, azalmış yumurtalık rezervi olan kadınlarda yapılan oosit toplama işleminde foliküler yıkama yapılmadan elde edilen oositler ile foliküler yıkama ile elde edilen oositler arasındaki gebelik ve canlı doğum oranlarını karşılaştırmayı amaçlamaktadır. Gereç ve Yöntemler: Çalışma 2017-2020 yılları arasında Bologna kriterlerine göre azalmış yumurtalık rezervi tanısı alan ve tüp bebek için kliniğe başvuran hastalar arasında yapılmıştır. Çalışmaya 21-42 yaş arası, 358 infertil kadın dahil edildi. Oosit toplama işleminde her bir folikül bir kez aspire edildi ve yumurta alındıysa diğer foliküle geçildi. Yumurta çıkmayan foliküller ise en fazla 3 defa yıkama yapılarak oosit alınmaya çalışıldı. Hem yıkamasız hem de yıkamalı oosit elde edilen hastalar çalışmadan çıkartıldı. Elde edilen oosit sayısı, klinik gebelik oranı ve canlı doğum oranı karşılaştırıldı. Bulgular: İki grup arasında ortalama MII oosit sayısı, canlı doğum oranları ve abortus oranları istatistiksel olarak anlamlı farklılık göstermedi. Foliküler yıkama yapılmayan grupta gebelik oranı daha yüksek bulundu. Sonuç: Azalmış overyan rezervi olan hastalarda oosit toplama sırasında uygulanan foliküler yıkama, elde edilen oosit sayısını, klinik gebeliği ve canlı doğum oranlarını olumlu yönde etkilemedi. Hatta bunu yapmak olası düşük kaliteli yumurta nedeniyle gebelik oranını düşürebilir, ancak eğer ilk başta yumurta elde edilmemiş hastalarda folikül yıkanmasaydı bu hastalarda hiçbir şekilde gebelik elde edilemeyecekti.
ABSTRACT
Objective: This study aims to compare the pregnancy and live birth rates between the oocytes retrieved without follicular flushing and those retrieved by follicular flushing in the oocyte pick-up procedure performed in women with diminished ovarian reserve. Materials and Methods: The study was conducted among patients diagnosed with diminished ovarian reserve according to Bologna criteria who applied to the clinic for IVF between 2017-2020. A total of 358 infertile women with follicles three and below on the hCG day were included, and each follicle was aspirated once in the OPU procedure, and if an egg was retrieved, the physician moved to the next follicle. If the egg could not be retrieved, the oocyte was tried to be retrieved by flushing the follicle a maximum of three times. The number of oocytes retrieved, clinical pregnancy, and live birth rates were compared. Results: The mean number of MII oocytes, rates of live births and the miscarriage rates between the two groups did not show any statistical difference. Pregnancy rates were higher in no follicular flushing group. Conclusion: Flushing of the follicles did not give the same pregnancy result as the oocytes aspirated without flushing, but we should not forget that if we did not do flushing after once we aspirated the follicle, we would not be able to obtain any pregnancy at all in these patients
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