{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T05:56:23Z","timestamp":1761198983475,"version":"build-2065373602"},"reference-count":19,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Ultrasound-guided transvaginal follicular aspiration is a central procedure in in vitro fertilisation (IVF), aiming to collect oocytes necessary for the success of assisted reproduction treatments. Follicular flushing, proposed in the absence of cumulo-oocyte complex (COC) at initial aspiration, remains controversial regarding its real impact on oocyte quality and pregnancy rates. Methods: In this controlled study, conducted in 274 patients, we evaluated the effects of systematic follicular flushing up to 10 washes with a standardised medium (pH 7.3 \u00b1 0.1; 37.2 \u00b1 0.2 \u00b0C) on oocyte yield, oocyte morphology, embryo kinetics and clinical outcomes. Results: Flushing resulted in an additional 38% recovery of COCs, mostly between the second and fifth flush, with no significant increase in oocyte dysmorphisms or major embryonic abnormalities. A slight increase in slow cleavages was observed (27% vs. 23%, p = 0.04), as well as a lower oocyte maturation rate when ovulation was triggered by Ovitrelle alone. Clinically, pregnancy rates per transfer were comparable between groups (33.27% without flushing vs. 32.86% with flushing; p = 0.67), as were miscarriage rates (9.11% vs. 8.69%; p = 0.81). Conclusions: These results indicate that follicular flushing, when applied according to a standardised protocol, significantly increases oocyte yield without compromising oocyte morphological quality or embryonic development potential. Although the observed clinical benefits remain modest, this approach could constitute a relevant complementary strategy, particularly in patients with poor ovarian response or in the context of poor initial recovery. However, the controlled but non-randomised nature of this study requires cautious interpretation of the findings. Larger randomised trials, integrating dynamic assessment technologies, such as time-lapse imaging or oocyte transcriptomic analysis, are needed to refine the clinical indications of this technique and explore its underlying biological mechanisms.<\/jats:p>","DOI":"10.3390\/jcm14217457","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T05:20:44Z","timestamp":1761196844000},"page":"7457","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Systematic Follicular Flushing on Egg Retrieval and Embryo Quality in IVF-ICSI Cycles: A Controlled Study?"],"prefix":"10.3390","volume":"14","author":[{"given":"Modou Mamoune","family":"Mbaye","sequence":"first","affiliation":[{"name":"Immunopathology-Immunotherapy-Immunomonitoring Laboratory, Faculty of Medicine, Mohammed VI University of Health and Sciences, Casablanca 20270, Morocco"},{"name":"Medical Analysis and Reproductive Biology Laboratory, Labomac, Casablanca 20270, Morocco"},{"name":"IRIFIV Fertility Center, IVF Laboratory and MSREM Scientific Research Group, Casablanca 20000, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noureddine","family":"Louanjli","sequence":"additional","affiliation":[{"name":"Medical Analysis and Reproductive Biology Laboratory, Labomac, Casablanca 20270, Morocco"},{"name":"IRIFIV Fertility Center, IVF Laboratory and MSREM Scientific Research Group, Casablanca 20000, Morocco"},{"name":"African Fertility Center, Private Clinic of Human Reproduction and Endoscopic Surgery, Casablanca 20000, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Ennaji","sequence":"additional","affiliation":[{"name":"IRIFIV Fertility Center, IVF Laboratory and MSREM Scientific Research Group, Casablanca 20000, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehdi","family":"Hissane","sequence":"additional","affiliation":[{"name":"IRIFIV Fertility Center, IVF Laboratory and MSREM Scientific Research Group, Casablanca 20000, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelaziz","family":"Soukri","sequence":"additional","affiliation":[{"name":"Laboratory of Pathophysiology, Molecular Genetics and Biotechnology, Ain Chock Faculty of Sciences, Biology and Health Research Center, Hassan II University of Casablanca, Casablanca 20670, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bouchra","family":"El Khalfi","sequence":"additional","affiliation":[{"name":"Laboratory of Pathophysiology, Molecular Genetics and Biotechnology, Ain Chock Faculty of Sciences, Biology and Health Research Center, Hassan II University of Casablanca, Casablanca 20670, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7032-2126","authenticated-orcid":false,"given":"Taha","family":"Rhouda","sequence":"additional","affiliation":[{"name":"Laboratory of Integrative Biology, Ben M\u2019Sik Faculty of Sciences, Hassan II University of Casablanca, Casablanca 20670, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelhafid","family":"Natiq","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, Mohammed V University, Rabat 10100, Morocco"},{"name":"National Laboratory Mohammed VI, Mohammed VI University of Health and Sciences, Casablanca 82403, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8623-3695","authenticated-orcid":false,"given":"Wassym Rhazi","family":"Senhaji","sequence":"additional","affiliation":[{"name":"IRIFIV Fertility Center, IVF Laboratory and MSREM Scientific Research Group, Casablanca 20000, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Zarqaoui","sequence":"additional","affiliation":[{"name":"IRIFIV Fertility Center, IVF Laboratory and MSREM Scientific Research Group, Casablanca 20000, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moncef","family":"Benkhalifa","sequence":"additional","affiliation":[{"name":"Reproductive Medicine, Reproductive Biology and Genetics, Peritox Laboratory, University Hospital and School of Medicine, Picardie University Jules Verne, 80054 Amiens, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasmine","family":"Louanjli","sequence":"additional","affiliation":[{"name":"Medical Analysis and Reproductive Biology Laboratory, Labomac, Casablanca 20270, Morocco"},{"name":"IRIFIV Fertility Center, IVF Laboratory and MSREM Scientific Research Group, Casablanca 20000, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bouchra","family":"Ghazi","sequence":"additional","affiliation":[{"name":"Immunopathology-Immunotherapy-Immunomonitoring Laboratory, Faculty of Medicine, Mohammed VI University of Health and Sciences, Casablanca 20270, Morocco"},{"name":"Mohamed VI Research and Innovation Center (CM6RI), Rabat 11103, Morocco"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"ref_1","first-page":"8921","article-title":"Effect of administration of piroxicam before embryo transfer on in-vitro fertilization outcome","volume":"10","author":"Kadhim","year":"2021","journal-title":"J. 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