Aspiration of excess follicles in ovulation induction cycles may reduce high order multiple pregnancies

Abstract

ObjectiveOvulation induction (OI) cycles with excess follicles place patients at increased risk for high order multiple gestation. Ultrasound guided follicular aspiration of excess follicles is a strategy for reducing the risk of high order multiple gestations and avoiding cycle cancellation. We compared pregnancy and multiple pregnancy rates in OI cycles with aspirated versus unaspirated cycles.DesignThis is a retrospective cohort study.Materials and methodsAll OI cycles between July 2001 and January 2004 were examined. Entry criteria included women less than 40 years of age, at least one patent fallopian tube and > 10 million motile sperm per ejaculate. Patients < 35 years of age with more than 4 follicles or >35 years of age with more than 6 follicles > 15 mm in size underwent transvaginal, unilateral follicular aspiration. IUIs were performed 30 to 35 hours after HCG administration.ResultsA total of 30 patients underwent aspiration of excess follicles. Aspirated patients had an average of 6.7 mature follicles (range 5–13) prior to aspiration and were reduced to an average of 4.0 follicles (range 2–6). Clinical pregnancy rate in the aspirated group was 30% vs. 26% in the unaspirated group. The aspirated group had a twin gestation rate of 44% vs 27% in the unaspirated group. There were no high order multiple pregnancies in the aspirated group versus 2.3% in the unaspirated group. This study is ongoing.ConclusionFollicular aspiration in high risk cycles is a viable option in OI cycles at high risk for multiple gestation. The use of technique avoids cycle cancellation, is associated with acceptable rates of pregnancy and minimizes the risk of high order multiple gestations. ObjectiveOvulation induction (OI) cycles with excess follicles place patients at increased risk for high order multiple gestation. Ultrasound guided follicular aspiration of excess follicles is a strategy for reducing the risk of high order multiple gestations and avoiding cycle cancellation. We compared pregnancy and multiple pregnancy rates in OI cycles with aspirated versus unaspirated cycles. Ovulation induction (OI) cycles with excess follicles place patients at increased risk for high order multiple gestation. Ultrasound guided follicular aspiration of excess follicles is a strategy for reducing the risk of high order multiple gestations and avoiding cycle cancellation. We compared pregnancy and multiple pregnancy rates in OI cycles with aspirated versus unaspirated cycles. DesignThis is a retrospective cohort study. This is a retrospective cohort study. Materials and methodsAll OI cycles between July 2001 and January 2004 were examined. Entry criteria included women less than 40 years of age, at least one patent fallopian tube and > 10 million motile sperm per ejaculate. Patients < 35 years of age with more than 4 follicles or >35 years of age with more than 6 follicles > 15 mm in size underwent transvaginal, unilateral follicular aspiration. IUIs were performed 30 to 35 hours after HCG administration. All OI cycles between July 2001 and January 2004 were examined. Entry criteria included women less than 40 years of age, at least one patent fallopian tube and > 10 million motile sperm per ejaculate. Patients < 35 years of age with more than 4 follicles or >35 years of age with more than 6 follicles > 15 mm in size underwent transvaginal, unilateral follicular aspiration. IUIs were performed 30 to 35 hours after HCG administration. ResultsA total of 30 patients underwent aspiration of excess follicles. Aspirated patients had an average of 6.7 mature follicles (range 5–13) prior to aspiration and were reduced to an average of 4.0 follicles (range 2–6). Clinical pregnancy rate in the aspirated group was 30% vs. 26% in the unaspirated group. The aspirated group had a twin gestation rate of 44% vs 27% in the unaspirated group. There were no high order multiple pregnancies in the aspirated group versus 2.3% in the unaspirated group. This study is ongoing. A total of 30 patients underwent aspiration of excess follicles. Aspirated patients had an average of 6.7 mature follicles (range 5–13) prior to aspiration and were reduced to an average of 4.0 follicles (range 2–6). Clinical pregnancy rate in the aspirated group was 30% vs. 26% in the unaspirated group. The aspirated group had a twin gestation rate of 44% vs 27% in the unaspirated group. There were no high order multiple pregnancies in the aspirated group versus 2.3% in the unaspirated group. This study is ongoing. ConclusionFollicular aspiration in high risk cycles is a viable option in OI cycles at high risk for multiple gestation. The use of technique avoids cycle cancellation, is associated with acceptable rates of pregnancy and minimizes the risk of high order multiple gestations. Follicular aspiration in high risk cycles is a viable option in OI cycles at high risk for multiple gestation. The use of technique avoids cycle cancellation, is associated with acceptable rates of pregnancy and minimizes the risk of high order multiple gestations.