Follicular flushing in natural cycle IVF does not affect the luteal phase - a prospective controlled study

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization (IVF)

Background:

• Follicular flushing may enhance monofollicular IVF efficacy, particularly in natural cycle IVF (NC-IVF).
• Concerns exist regarding potential negative impacts of follicular flushing on luteal phase length and endocrine function due to granulosa cell loss.

Purpose of the Study:

• To prospectively evaluate the effect of follicular flushing during NC-IVF on luteal phase length and luteal phase hormone concentrations.

Main Methods:

• A prospective cohort Phase II study involving 24 women undergoing NC-IVF.
• Comparison of a reference cycle (hCG-induced ovulation, no follicle aspiration) with an NC-IVF cycle (follicles aspirated and flushed three times).
• Analysis included luteal phase length, luteal progesterone, and estradiol concentrations.

Main Results:

• No significant difference in median luteal phase length between the reference cycle (13 days) and the NC-IVF (flushing) cycle (14 days).
• Follicular flushing did not significantly alter median progesterone or estradiol concentrations during the luteal phase.
• Luteal phase length was shorter in 29.2%, equal in 16.7%, and longer in 50.0% of cases following flushing.

Conclusions:

• Follicular flushing in NC-IVF does not appear to negatively impact luteal phase length or endocrine function.
• The findings question the routine need for luteal phase supplementation following follicular flushing in NC-IVF.