CClinicalTrials.gg
CompletedNCT01558141Updated Jan 14, 2019

Follicular Flushing

An interventional study of Aspiration without flushing follicles with culture media and Follicular Flushing in Fertilization, sponsored by Weill Medical College of Cornell University. Completed at 1 site in United States. Open to female participants aged 18 Years to 45 Years. Per ClinicalTrials.gov, last updated 2019-01-14.

Sponsored by Weill Medical College of Cornell University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
50
Allocation
Randomized
Ages
18 Years to 45 Years
Sex
Female
01

Study summary

Patients with infertility often undergo in vitro fertilization (IVF) to achieve a pregnancy, which involves ovarian stimulation, monitoring of follicular growth, oocyte retrieval, sperm insemination, embryo culture and embryo transfer.

The oocytes are removed during surgery by aspirating the follicles using a single lumen needle with an ultrasound to guide the procedure. There is some data that flushing the follicles with embryo culture media before aspiration using a double lumen needle increases the number of oocytes retrieved, particularly among poor responding patients for whom each additional oocyte recovered may substantially alter the outcome of that IVF cycle.

The objective of the research is to evaluate the effect of follicular flushing in poor responders on IVF cycle outcomes.

Read the detailed description

Patients with infertility often undergo in vitro fertilization (IVF) to achieve a pregnancy, which involves ovarian stimulation, monitoring of follicular growth, oocyte retrieval, sperm insemination, embryo culture and embryo transfer. The number of embryos obtained is dependent on the number of oocytes retrieved.

The objective of the research is to evaluate the effect of follicular flushing in poor responders on IVF cycle outcomes, including the number of oocytes retrieved, number of mature oocytes, fertilization rate, number of embryos transferred, implantation rate, miscarriage rate, live birth rate, operating room time, and luteal estradiol and progesterone levels.

The research entails a prospective, randomized, controlled trial of poor-responder patients who are undergoing IVF treatment at The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, defined as patients who have ≤ 4 follicles that are ≥ 12mm on the day of hCG trigger.

Patients identified as poor responders will be consented and randomized to follicular flushing versus aspiration without flushing. A 2-5mL flush using embryo culture media followed by aspiration of the follicle will be performed in the patients randomized to the flushing group, with subsequent flushes until an oocyte is identified or up to 4 flushes maximum.

Patients being enrolled in this research study will undergo IVF regardless of participation in this research study.

Randomization:

A series of randomized blocks of 2 will be generated for the study. This will provide assurance that after two patients are enrolled, there will be one patient assigned to each group- follicular flushing versus aspiration without flushing. This process of blocked randomization ensures an equal distribution between the two study arms of patients.

02

Conditions studied

  • Fertilization

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Keywords

  • IVF stimulation.
  • Poor responders.
  • IVF patients with poor response to stimulation
03

Who can participate

Ages eligible
18 Years to 45 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Pts ages 18-45 undergoing IVF
  • Pts with ≤ 4 follicles that are ≥ 12mm on day of HCG

Exclusion criteria

Exclusion Criteria:

  • Pts undergoing natural cycles (i.e. those with intentionally low # of follicles)
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
50 participants (actual)

Study arms

  • Active comparator
    Follicular flushing

    Flushing follicles with embryo culture media prior to aspiration.

    Other: Aspiration without flushing follicles with culture media · Other: Follicular Flushing

Interventions

  • OtherAspiration without flushing follicles with culture media

    Aspiration without flushing follicles with culture media.

  • OtherFollicular Flushing

    Flushing follicles with embryo culture media prior to aspiration.

05

What researchers measure

Primary outcomes

  1. FOLLICULAR FLUSHING ON CYCLE OUTCOMES IN POOR RESPONDERS

    To evaluate the number of oocytes retrieved with follicular flushing in poor responders

    Time frame: 2 weeks

Secondary outcomes

  1. FOLLICULAR FLUSHING ON CYCLE OUTCOMES IN POOR RESPONDERS

    To evaluate: - # of embryos transferred

    Time frame: 2 weeks

  2. FOLLICULAR FLUSHING ON CYCLE OUTCOMES IN POOR RESPONDERS

    Fertilization rates.

    Time frame: 2 weeks

  3. FOLLICULAR FLUSHING ON CYCLE OUTCOMES IN POOR RESPONDERS

    Implantation rates

    Time frame: 2 weeks

  4. FOLLICULAR FLUSHING ON CYCLE OUTCOMES IN POOR RESPONDERS

    Pregnancy rates

    Time frame: 2 weeks

  5. FOLLICULAR FLUSHING ON CYCLE OUTCOMES IN POOR RESPONDERS

    Live birth rates

    Time frame: 2 weeks

  6. FOLLICULAR FLUSHING ON CYCLE OUTCOMES IN POOR RESPONDERS

    Operating room anesthesia time.

    Time frame: 2 weeks

  7. FOLLICULAR FLUSHING ON CYCLE OUTCOMES IN POOR RESPONDERS

    Luteal E2 level.

    Time frame: 2 weeks

  8. FOLLICULAR FLUSHING ON CYCLE OUTCOMES IN POOR RESPONDERS

    Luteal P4 level.

    Time frame: 2 weeks

06

Study locations

1 site
  • New York Presbyterian Hospital
    New York, New York 10065, United States
07

References and documents

Publications

  • Mok-Lin E, Brauer AA, Schattman G, Zaninovic N, Rosenwaks Z, Spandorfer S. Follicular flushing and in vitro fertilization outcomes in the poorest responders: a randomized controlled trial. Hum Reprod. 2013 Nov;28(11):2990-5. doi: 10.1093/humrep/det350. Epub 2013 Sep 5. PubMed 24014603 ↗
08

Registry details

Key details

Study ID
NCT01558141
Lead sponsor
Weill Medical College of Cornell University
Responsible party
Sponsor
First posted
Mar 20, 2012
Start date
Sep 2011
Primary completion
May 2013
Completion
May 2013
Last update
Jan 14, 2019

Study contacts

Steven D. Spandorfer, MD
principal investigator · Weill Medical College of Cornell

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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