{"paper_id":"3f5cbd6c-9db0-4bd6-b8b8-d241c26bfa02","body_text":"Comparison of cumulative live birth rates between oocyte retrieval using single-lumen and double-lumen needles: a self-controlled retrospective cohort study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparison of cumulative live birth rates between oocyte retrieval using single-lumen and double-lumen needles: a self-controlled retrospective cohort study Xiaoxia Zhang, Li Sun, Jianping Ou, Shuqi Ge This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6975589/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose We investigate the clinical value of double-lumen needle oocyte retrieval in patients with diminished ovarian reserve (DOR) undergoing in vitro fertilization-embryo transfer (IVF-ET), and to analyze its effects on oocyte retrieval rate, embryo quality, and pregnancy outcomes. Methods This single-center retrospective cohort study analyzed data from 70 patients undergoing 277 oocyte retrieval cycles over a 5-year period (153 cycles with single-lumen needles versus 124 with double-lumen needles). Comprehensive comparisons were made between the two groups regarding embryological parameters (fertilization rates, embryo quality) and clinical outcomes (implantation rates, pregnancy outcomes). Results For the same cohort of patients, despite increased age and decreased Anti-Müllerian Hormone (AMH) levels at the time of oocyte retrieval using double-lumen needle, the percentage of oocyte-obtained cycles showed a non-significant trend toward improvement with double-lumen needles compared to single-lumen needles (91.94% vs 86.93%, p = 0.182). The rates of oocyte retrieval, day 3 good-quality embryos, clinical pregnancy, implantation and live birth, and the cumulative live birth, no statistically significant differences between the two groups (all p > 0.05). Conclusions In the same patient cohort, ‌despite advancing oocyte retrieval age, prolonged duration of infertility, and declining ovarian reserve function‌, double-lumen needle oocyte retrieval achieved ‌comparable embryo culture outcomes‌ and ‌equivalent clinical outcomes‌ to single-lumen needle retrieval. double-lumen needle oocyte retrieval diminished ovarian reserve assisted reproductive technology oocyte retrieval rate Embryo Transfer‌ Introduction Transvaginal oocyte retrieval is the most common surgical operation for obtaining oocytes in assisted reproduction techniques(ART). [ 1 – 2 ] With the rapid development of ART, the choice of puncture needles for oocyte retrieval is becoming more diverse. [ 3 – 4 ] Women with poor ovarian reserve or combined advanced reproductive age (≥ 35 years) confront multifactorial challenges of a decrease in oocyte retrieval rate(ORR), increased rates of embryonic aneuploidy and miscarriage, decreased live birth rates. [ 5 – 6 ] In order to improve ORR in such patients, clinical attempts have been made to use double lumen needles for oocyte retrieval. [ 7 – 8 ] This ‌bidirectional fluid dynamics‌ enhances oocyte-cumulus complex dislodgement efficiency. However, the repeated rinsing of follicles during oocyte retrieval with double-lumen needles may also cause mechanical damage to the oocytes and affect the quality of the embryos, and the price of double-lumen needles is more expensive than that of single-lumen needles, and multiple rinsing of each follicle during double-lumen oocyte, may increase surgical time and the risk of surgical accidents. These concerns have limited the wide application of double-lumen needles in clinical practice. In this study, we analyzed the data related to ORR, embryo culture outcome, clinical pregnancy rate, and live birth rate of different cycles of single or double-lumen needles in the same patient at our center, and explored the prospect of the clinical application of double-lumen needles for oocyte retrieval. Materials and methods Study design This retrospective self-controlled study analyzed patients undergoing multiple oocyte retrieval cycles at the Reproductive Medicine Center of The Third Affiliated Hospital of Sun Yat-sen University (January 2019 - December 2024). The cohort included patients with ≤ 5 follicles > 14 mm in diameter on hCG trigger day across sequential cycles. Intra-patient comparisons were stratified by aspiration needle type: Single-lumen needle group (S-LN Group) and Double-lumen needle group (D-LN Group). Our study was conducted in strict accordance with the ‌Declaration of Helsinki‌ (2013 revision). The study was approved by the Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University (approval number: II2025-155). All participants provided written informed consent. Ovarian stimulation protocols were predominantly managed with GnRH antagonist protocol, minimal stimulation protocol, natural cycle protocol. When the dominant follicle was > 14mm, 5000-10000IU of human chorionic gonadotropin (HCG) was given to the trigger. Transvaginal ultrasound-guided posterior fornix puncture for oocyte retrieval at 36-38h post-trigger. In the S-LN Group, a 17G single-lumen needle (Wallace, Cooper Surgical, Denmark) was inserted into the puncture guide device, and the follicular fluid was aspirated with a suction of 100–120 mmHg. As for the patients in D-LN Group, the clinician punctured the follicle using a 17G double-lumen needle (Wego, Shandong Wego Ruisheng Medical Device Co., Ltd) under ultrasound guidance, and one channel was used to aspirate the follicular fluid, while the other channel was injected with PBS culture fluid, and each follicle was rinsed and aspirated several times. The collected oocytes were incubated for at least two hours and then selected for insemination according to the IVF/ICSI indications in combination with the concentration and viability of the male partner's semen. Routine luteal phase support is administered following embryo transfer; serum β-HCG levels were measured 14 d after embryo transfer, when serum HCG values were positive, a pregnancy was determined to be clinical if a gestational sac and a pulsating fetal heart were seen by vaginal ultrasonography at 4 to 5 weeks after embryo transfer. Delivery of a live infant at 28 weeks of gestation was considered a live birth. Study outcomes The main indicators to be observed are ORR(number of oocyte obtained/number of follicles punctured×100%), normal fertilization rate༈IVF number of 2PN/number of oocyte obtained×100%, ICSI number of 2PN /number of mature oocyte injected×100%༉, available embryo rates༈number of embryo transferred plus number of embryos frozen/number of 2PN cleavage plus number of pb cleavage plus number of 1PN cleavage༉, high-quality embryo rate༈number of high-quality embryos /number of 2PN cleavage× 100%༉, followed by clinical pregnancy rate (number of clinical pregnancy cycles/total number of cycles transferred × 100%, miscarriage rate (number of miscarriage cycles/number of clinical pregnancy cycles × 100%), and live birth rate (number of cycles with live births/total number of cycles transferred × 100%). Statistical analysis Statistical analyses were conducted using SPSS version 26.0 (IBM Corp., Armonk, NY, USA). Continuous variables with normal distribution were presented as mean ± standard deviation and compared using independent samples t -test; count data were expressed using the constitutive ratio or rate (%), and comparisons of count data were made using the chi-square test or Fisher's exact probability method. The difference was considered statistically significant when P < 0.05. Results A total of 70 patients were included in this study, with a total of 277 cycles of oocyte retrieval, of which 153 cycles were retrieved using single-lumen needle and 124 cycles were retrieved using double-lumen needle. The age and infertility years of the women in D-LN Group were slightly higher, and the number of antral follicle count(AFC) was lower, but the difference was not statistically significant. The AMH level, the number of follicles > 14mm on HCG triggered day, and the average number of oocyte obtained were significantly lower in the D-LN Group than in the S-LN Group, and the difference was statistically significant. (Table 1 ) Table 1 Baseline characteristics between two groups Variable S-LN Group D-LN Group P-value Number of cases 70 70 Total number of cycles 153 124 AMH (ng/ml) 0.70 ± 0.58 0.51 ± 0.44 0.028* Female patient age 39.35 ± 5.25 40.79 ± 5.01 0.100 Duration of infertility 4.37 ± 3.86 4.97 ± 3.87 0.361 antral follicle count(AFC) 3.87 ± 1.84 3.44 ± 1.31 0.110 Number of follicles > 14mm on HCG day 2.18 ± 1.09 1.75 ± 0.75 0.007* Mean number of oocyte obtained 2.24 ± 1.60 1.77 ± 1.16 0.004* Protocols GnRH antagonist protocol 64/153 (41.83) 59/124 (47.58) 0.061 minimal stimulation protocol 58/153 (37.91) 31/124 (25.00) natural cycle protocol 14/153 (9.15) 21/124 (16.94) Other protocols 17/153 (11.11) 13/124 (10.48) Values are presented as mean ± standard deviation; BMI, body mass index; AMH, anti-Müllerian hormone; FSH, follicle stimulating hormone; AFC, Antral Follicle Count The percentage of oocyte-obtaining cycles in D-LN Group was higher than that in S-LN Group (91.94% vs. 86.93%), but the difference was not statistically significant ( P = 0.182), and the differences in the overall ORR, normal fertilization rate, usable embryo rate, and high-quality embryo rate of the two methods of oocyte retrieval were not statistically significant. (Table 2 ) Table 2 Laboratory cultivation parameters between two groups Variable S-LN Group D-LN Group P-value Percentage of oocyte-obtained cycles (%) 133/153 (86.93) 114/124 (91.94) 0.182 oocyte retrieval rate (%) 343/489 (70.14) 219/311 (70.42) 0.934 Normal fertilization rate (%) 221/334 (66.17) 132/211 (62.56) 0.390 Rate of available embryos (%) 200/229 (87.34) 122/138 (88.41) 0.762 high-quality embryo rate (%) 78/218 (35.78) 51/126 (40.48) 0.386 Live birth rate of embryo transfer in the two groups a total of 90 cycles of S-LN were transferred, of which 32 were fresh transfer cycles and 58 were frozen embryo transfer cycles, and a total of 50 cycles of D-LN were transferred, of which 19 were fresh transfer cycles and 31 were frozen embryo transfer cycles. (Table 3 ). Table 3 Live birth rates of embryo transfer between two groups Variable S-LN Group fresh ET D-LN Group fresh ET P-value S-LN Group FET D-LN Group FET P-value Total number of cycles 32 19 58 31 Clinical pregnancy rate (%) 4/32 (12.50) 4/19 (21.05) 0.450 11/54(20.37) 7/31 (22.58) 0.810 abortion rate (%) 1/4 (25.00) 0 6/11 (54.55) 2/7 (28.57) 0.367 live birth rate (%) 3/32 (9.38) 4/19 (21.05) 0.402 5/58 (8.62) 5/31 (16.13) 0.285 ET, embryo transfer; FET, frozen embryo transfer A total of 70 patients were included in this study, of which 27 patients had embryos that were not fully thawed or embryos that had been discarded from the oocyte retrieval cycle, and 43 patients had all their embryos utilized (8 thawed with a mixture of single and double lumen needle embryos), so only the cumulative live birth rates of these 35 patients will be discussed in this study. (Table 4 ). Table 4 Cumulative live birth rate between two groups Variable S-LN Group D-LN Group P-value Number of fresh transplant cycles 17 9 clinical pregnancy rate (%) 3/17 (17.65) 3/9 (33.33) 0.669 abortion rate (%) 1/3 (33.33) 0 Number of cycles of frozen embryo transfer 24 23 Clinical pregnancy rate(%) 2/24 (8.3) 3/23 (13.04) 0.666 abortion rate (%) 0 0 Cumulative pregnancy rate (%) 5/41 (12.20) 6/32 (18.75) 0.437 Cumulative live birth rate (%) 4/41 (9.76) 6/32 (18.75) 0.271 Discussion Oocyte retrieval is one of the key steps in assisted reproduction. [ 9 ] Obtaining a satisfactory number of oocytes is a prerequisite for a series of subsequent embryo cultures and embryo transfers, and how to maximize the rate of oocyte retrieval in patients with fewer follicles is a difficult problem that needs to be pondered. With the development of ART, double lumen needles are gradually being used for oocyte retrieval in clinical practice, which can be used to pump follicular fluid while injecting culture fluid to rinse the inner wall of the follicle directly, and to minimize the residual of oocytes, especially for those oocytes that are deeply located or tightly adhered to the follicular wall. Our center is gradually promoting the use of double lumen needles after 2021 in patients with few follicles (patients with 1–5 follicles with a diameter of 14 mm or more follicles on the trigger day), who have difficulty in obtaining live births in a single oocyte retrieval cycle due to the low number of oocyte acquired and the difficulty in the formation of viable embryos. In order to accumulate embryos, several cycles of ovulation induction are experienced. In this study, a before-and-after controlled analysis of such patients was performed, including all cycles of oocyte retrieval, and analyzing the cultured embryos and the clinical outcome according to the oocyte retrieval and puncture needles used registered on the day of the procedure. The present study included the number of all cycles of oocyte retrieval from January 2019 to December 2024 in 70 patients, who had a total of 277 cycles of oocyte retrieval (of which the group using single-lumen needle 153 cycles and 124 cycles in the group using double lumen needle), experiencing at least one single lumen needle oocyte retrieval, one double lumen needle oocyte retrieval, or even multiple oocyte retrievals, with number of oocyte retrieved, fertilization, eugenic embryos, and available embryos expressed as percentages, and an overall assessment of whether or not the use of double lumen needle oocyte retrieval results in a clinical outcome similar to that of the single lumen needle as patients' age at oocyte retrieval increases and their ovarian reserve function decreases, although the the number of follicles > 14 mm on HCG days 、AMH and the mean number of oocyte obtained in the group using double lumen needle were significantly lower than that in the group using single lumen needle oocyte retrieval, and the difference was statistically significant, but when analyzing the cumulative live birth rate, we found that although the age of the group using double lumen needle increased and the ovarian function declined, the cumulative pregnancy rate and cumulative live birth rate obtained were comparable to the results of the group using single lumen needle. One RCT study concluded that using a double-lumen needle during oocyte retrieval in patients with single follicular development, the oocyte retrieval rate was only 25%, and the oocyte retrieval rate could be increased to 83% after five rinses, repeated rinses did not affect the oocyte maturation rate or embryo quality; [ 10 ] One study concluded that double-lumen needle could increase the oocyte retrieval rate and maturation rate in patients with single follicular development. [ 11 ] Two prospective controlled studies concluded that using double lumen needles in poorly responding patients resulted in a lower rate of oocyte retrieval and prolonged procedure time. [ 12 – 13 ] A Cochrane review concluded that for both poorly responding and normally responding patients, oocyte retrieval using double lumen needles had no benefit. [ 14 ] Many scholars have studied the efficacy after using single and double lumen needle oocyte retrieval, but the total population included was based on the population with no difference in baseline data, and one of the more prominent strengths of this study is that it included the same population using single and double lumen needles, and this group of patients were all experiencing at least one or more single and double lumen needle oocyte retrieval, which firstly eliminated the influence on the study outcome due to individual patient differences, and reduced the study's confounding factors. In patients with reduced ovarian function, it is often difficult to achieve the goal of live birth with a single oocyte retrieval. When analyzing live births, this study analyzed the live births of fresh embryo transfer and frozen embryo transfer in both the single and double lumen groups and did a comparison of the cumulative live birth rates of the two methods of oocyte retrieval, and found that under the premise that the underlying AFC were similar in the two groups, even though there was an increase in the age of oocyte retrieval and a decline in ovarian function the percentage of oocyte-obtained cycles was increased in the double-lumen needle group compared with that in the group using a single lumen needle and the rate of normal fertilization, high-quality embryo rate, cumulative pregnancy rate and cumulative live birth rate were similar, suggesting that the use of double lumen needle is more beneficial to the patients in case of increasing age and declining ovarian function. Oocyte retrieval rate is one of the most important factors affecting the live birth rate in assisted reproduction, especially in women with fewer follicles, where one more precious oocyte may result in one more chance of embryo transfer. [ 15 – 16 ] In this group of patients, who usually undergo more than one ovarian stimulation cycle, if the oocyte retrieval rate can be improved through the use of the double lumen needle technique in each oocyte retrieval procedure, the financial and psychological pressure on the patient will be greatly reduced. The limitations of this study are that it is a retrospective study, the fertilization method of the two populations is mainly IVF, and it is not possible to visually compare the rate of oocyte degeneration on the day of oocyte retrieval, and it is not possible to analyze whether the use of multiple rinses with a double-lumen needle for oocyte retrieval leads to an increase in the rate of degeneration. In conclusion, this study concluded that for the same patient, by using double lumen needle ovulation after versus before using single lumen needle ovulation, it was found that there was a tendency to increase the oocyte retrieval rate and the percentage of oocyte-obtained cycles with increasing age of the female partner, prolonged years of infertility, and further decline in ovarian reserve, suggesting the necessity of using double lumen needle ovulation in patients with poor ovarian reserve. In the future, it is hoped that more cases will be included to analyze whether the use of double-lumen needle oocyte retrieval is beneficial in patients with poor ovarian response to increase the chances of implantation, and to increase the rate of live births. Declarations Author Contribution Xiaoxia Zhang: Conceptualization, Data curation, Writing-original draft Li Sun: Data curationJianping Ou: MethodologyShuqi Ge: Supervision, Writing-review & editing References Gembruch U, Diedrich K, Welker B, et al.‌ Transvaginal sonographically guided oocyte retrieval for in-vitro fertilization. Hum Reprod. 1988;3(Suppl 2):59–63. DOI:‌ 10.1093/oxfordjournals.humrep.a136799 Ludwig AK, Glawatz M, Griesinger G, et al.‌ Perioperative complications of transvaginal ultrasound-guided oocyte retrieval Hum Reprod. 2006;21(12):3235–3240. DOI:‌ 10.1093/humrep/del278 Iainas G, Iainas T, Kolibianakis E.‌ The importance of follicular flushing in optimizing oocyte retrieval. Curr Opin Obstet Gynecol. 2023;35(3):238–245. DOI:‌ 10.1097/GCO.0000000000000868 Nakagawa K, Nishi Y, Kaneyama M, et al.‌ Newly designed needle reduces pain during single-follicle oocyte retrieval. J Reprod Infertil. 2015;16(4):207–211. DOI:‌ 10.18502/jri.v16i4.2143 Yi Y, Fu J, Xie S, et al.‌ Ovarian reserve and spontaneous miscarriage: shared genetic architecture. Hum Reprod. 2023; 38 ( 11 ): 2247–2258 . DOI:‌ 10.1093/humrep/dead181 Busnelli A, Somigliana E, Cirillo F, et al.‌ Diminished ovarian reserve as miscarriage risk factor: meta-analysis. Hum Reprod Update. 2021; 27 ( 6 ): 973–988 . DOI:‌ 10.1093/humupd/dmab021 Ronchetti C, Cirillo F, Immediata V, et al.‌ RCT comparing single/double-lumen needles in ART Reprod Sci. 2023; 30 ( 9 ): 2866–2875 . DOI:‌ 10.1007/s43032-023-01239-3 Cimpeanu R, Castrejón-Pita AA, Lim LN, et al.‌ Flow-based design for double-lumen needles J Biomech. 2023; 160:111832. DOI:‌ 10.1016/j.jbiomech.2023.111832 Maldonado Rosas I, Anagnostopoulou C, Singh N, et al.‌ Optimizing oocyte retrieval and embryo transfer techniques Panminerva Med. 2022;64(2):156–170. DOI:‌ 10.23736/S0031-0808.21.04508-3 Kohl Schwartz AS, Calzaferri I, Roumet M, et al.‌ Follicular flushing increases oocyte yield in monofollicular IVF: RCT Hum Reprod. 2020;35(10):2253–2261. DOI:‌ 10.1093/humrep/deaa186 Pabuccu EG, Arslanca T, Ucar U, et al.‌ Double-lumen needle benefits mono-follicular poor responders J Gynecol Obstet Hum Reprod. 2021;50(9):102150. DOI:‌ 10.1016/j.jogoh.2021.102150 Calabre C, Schuller E, Goltzene MA, et al.‌ Follicular flushing vs direct aspiration in poor responders: RCT. Eur J Obstet Gynecol Reprod Biol. 2020;248:118–122. DOI:‌ 10.1016/j.ejogrb.2020.03.023 Souza MM, Mancebo ACA, Souza MDCB, et al.‌ Evaluation of follicular flushing with double-lumen needle in ART. JBRA Assist Reprod. 2021; 25 ( 2 ): 272–275 . DOI:‌ 10.5935/1518-0557.20210003 Georgiou EX, Melo P, Brown J, et al.‌ Cochrane review: follicular flushing during oocyte retrieval. Cochrane Database Syst Rev. 2018;4(4):CD004634. DOI:‌ 10.1002/14651858.CD004634.pub3 Jamil M, Debbarh H, Kabit A, et al.‌ Impact of oocyte number on IVF outcomes. Zygote. 2023;31(1):91–96. DOI:‌ 10.1017/S0967199422000482 Magnusson Å, Källen K, Thurin-Kjellberg A, et al.‌ Oocyte retrieval number: balancing efficacy and safety. Hum Reprod. 2018;33(1):58–64. DOI:‌ 10.1093/humrep/dex334 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-6975589\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":508629009,\"identity\":\"2df485ca-a56d-4a2a-a956-3afcc838c0ba\",\"order_by\":0,\"name\":\"Xiaoxia Zhang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Sun Yat-sen University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Xiaoxia\",\"middleName\":\"\",\"lastName\":\"Zhang\",\"suffix\":\"\"},{\"id\":508629010,\"identity\":\"9c848f05-3fd8-404d-bce9-8e93b487e2b5\",\"order_by\":1,\"name\":\"Li Sun\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Sun Yat-sen University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Li\",\"middleName\":\"\",\"lastName\":\"Sun\",\"suffix\":\"\"},{\"id\":508629011,\"identity\":\"06e04022-e93f-42cd-80a8-30862e893a17\",\"order_by\":2,\"name\":\"Jianping Ou\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Sun Yat-sen University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Jianping\",\"middleName\":\"\",\"lastName\":\"Ou\",\"suffix\":\"\"},{\"id\":508629012,\"identity\":\"2fa8db57-1884-4c3c-bf22-d13a64781d5f\",\"order_by\":3,\"name\":\"Shuqi Ge\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAsklEQVRIiWNgGAWjYLCCBAZmOTb29gOkaTHm4zmTQJI9zInzJBwMiFMr7394m8TDHdbpbRJAy35UbCOsxfBGWplE4pn03DbpxgOMPWduE6FlBo/ZjcS2w7ltMgcSmBnbiNHSfwasJZ1NIsGAOC3yDDlgLQnEazGQSCv/kdiWbtgGDOSDRPlFvv/wZsOfbdby8u3tBx/8qCDGlgMMiOg4QFg9yJYGBiJjcBSMglEwCkYuAAB35zyHNUzdJgAAAABJRU5ErkJggg==\",\"orcid\":\"\",\"institution\":\"Sun Yat-sen University\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Shuqi\",\"middleName\":\"\",\"lastName\":\"Ge\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2025-06-25 14:08:22\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-6975589/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-6975589/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":94657137,\"identity\":\"6478891b-9fe2-4bf5-a6a0-a89752914776\",\"added_by\":\"auto\",\"created_at\":\"2025-10-29 10:53:33\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":497083,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-6975589/v1/9b40e90a-cb09-46c6-a412-f31d9e1260be.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Comparison of cumulative live birth rates between oocyte retrieval using single-lumen and double-lumen needles: a self-controlled retrospective cohort study\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eTransvaginal oocyte retrieval is the most common surgical operation for obtaining oocytes in assisted reproduction techniques(ART). [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e] With the rapid development of ART, the choice of puncture needles for oocyte retrieval is becoming more diverse. [\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e] Women with poor ovarian reserve or combined advanced reproductive age (\\u0026ge;\\u0026thinsp;35 years) confront multifactorial challenges of a decrease in oocyte retrieval rate(ORR), increased rates of embryonic aneuploidy and miscarriage, decreased live birth rates. [\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e] In order to improve ORR in such patients, clinical attempts have been made to use double lumen needles for oocyte retrieval. [\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e] This \\u0026zwnj;bidirectional fluid dynamics\\u0026zwnj; enhances oocyte-cumulus complex dislodgement efficiency.\\u003c/p\\u003e\\u003cp\\u003eHowever, the repeated rinsing of follicles during oocyte retrieval with double-lumen needles may also cause mechanical damage to the oocytes and affect the quality of the embryos, and the price of double-lumen needles is more expensive than that of single-lumen needles, and multiple rinsing of each follicle during double-lumen oocyte, may increase surgical time and the risk of surgical accidents. These concerns have limited the wide application of double-lumen needles in clinical practice. In this study, we analyzed the data related to ORR, embryo culture outcome, clinical pregnancy rate, and live birth rate of different cycles of single or double-lumen needles in the same patient at our center, and explored the prospect of the clinical application of double-lumen needles for oocyte retrieval.\\u003c/p\\u003e\"},{\"header\":\"Materials and methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003eStudy design\\u003c/h2\\u003e\\u003cp\\u003eThis retrospective self-controlled study analyzed patients undergoing multiple oocyte retrieval cycles at the Reproductive Medicine Center of The Third Affiliated Hospital of Sun Yat-sen University (January 2019 - December 2024). The cohort included patients with \\u0026le;\\u0026thinsp;5 follicles\\u0026thinsp;\\u0026gt;\\u0026thinsp;14 mm in diameter on hCG trigger day across sequential cycles. Intra-patient comparisons were stratified by aspiration needle type: Single-lumen needle group (S-LN Group) and Double-lumen needle group (D-LN Group). Our study was conducted in strict accordance with the \\u0026zwnj;Declaration of Helsinki\\u0026zwnj; (2013 revision). The study was approved by the Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University (approval number: II2025-155). All participants provided written informed consent.\\u003c/p\\u003e\\u003cp\\u003eOvarian stimulation protocols were predominantly managed with GnRH antagonist protocol, minimal stimulation protocol, natural cycle protocol. When the dominant follicle was \\u0026gt;\\u0026thinsp;14mm, 5000-10000IU of human chorionic gonadotropin (HCG) was given to the trigger. Transvaginal ultrasound-guided posterior fornix puncture for oocyte retrieval at 36-38h post-trigger. In the S-LN Group, a 17G single-lumen needle (Wallace, Cooper Surgical, Denmark) was inserted into the puncture guide device, and the follicular fluid was aspirated with a suction of 100\\u0026ndash;120 mmHg. As for the patients in D-LN Group, the clinician punctured the follicle using a 17G double-lumen needle (Wego, Shandong Wego Ruisheng Medical Device Co., Ltd) under ultrasound guidance, and one channel was used to aspirate the follicular fluid, while the other channel was injected with PBS culture fluid, and each follicle was rinsed and aspirated several times.\\u003c/p\\u003e\\u003cp\\u003eThe collected oocytes were incubated for at least two hours and then selected for insemination according to the IVF/ICSI indications in combination with the concentration and viability of the male partner's semen. Routine luteal phase support is administered following embryo transfer; serum β-HCG levels were measured 14 d after embryo transfer, when serum HCG values were positive, a pregnancy was determined to be clinical if a gestational sac and a pulsating fetal heart were seen by vaginal ultrasonography at 4 to 5 weeks after embryo transfer. Delivery of a live infant at 28 weeks of gestation was considered a live birth.\\u003c/p\\u003e\\u003c/div\\u003e\\n\\u003ch3\\u003eStudy outcomes\\u003c/h3\\u003e\\n\\u003cp\\u003eThe main indicators to be observed are ORR(number of oocyte obtained/number of follicles punctured\\u0026times;100%), normal fertilization rate༈IVF number of 2PN/number of oocyte obtained\\u0026times;100%, ICSI number of 2PN /number of mature oocyte injected\\u0026times;100%༉, available embryo rates༈number of embryo transferred plus number of embryos frozen/number of 2PN cleavage plus number of pb cleavage plus number of 1PN cleavage༉, high-quality embryo rate༈number of high-quality embryos /number of 2PN cleavage\\u0026times; 100%༉, followed by clinical pregnancy rate (number of clinical pregnancy cycles/total number of cycles transferred \\u0026times; 100%, miscarriage rate (number of miscarriage cycles/number of clinical pregnancy cycles \\u0026times; 100%), and live birth rate (number of cycles with live births/total number of cycles transferred \\u0026times; 100%).\\u003c/p\\u003e\\u003cdiv id=\\\"Sec5\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003eStatistical analysis\\u003c/h2\\u003e\\u003cp\\u003eStatistical analyses were conducted using SPSS version 26.0 (IBM Corp., Armonk, NY, USA). Continuous variables with normal distribution were presented as mean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;standard deviation and compared using independent samples \\u003cem\\u003et\\u003c/em\\u003e-test; count data were expressed using the constitutive ratio or rate (%), and comparisons of count data were made using the chi-square test or Fisher's exact probability method. The difference was considered statistically significant when P\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05.\\u003c/p\\u003e\\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eA total of 70 patients were included in this study, with a total of 277 cycles of oocyte retrieval, of which 153 cycles were retrieved using single-lumen needle and 124 cycles were retrieved using double-lumen needle. The age and infertility years of the women in D-LN Group were slightly higher, and the number of antral follicle count(AFC) was lower, but the difference was not statistically significant. The AMH level, the number of follicles\\u0026thinsp;\\u0026gt;\\u0026thinsp;14mm on HCG triggered day, and the average number of oocyte obtained were significantly lower in the D-LN Group than in the S-LN Group, and the difference was statistically significant. (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e)\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eBaseline characteristics between two groups\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"5\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e\\u003cp\\u003eVariable\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eS-LN Group\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eD-LN Group\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003eP-value\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e\\u003cp\\u003eNumber of cases\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e70\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e70\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e\\u003cp\\u003eTotal number of cycles\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e153\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e124\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e\\u003cp\\u003eAMH (ng/ml)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0.70\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.58\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.51\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.44\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.028*\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e\\u003cp\\u003eFemale patient age\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e39.35\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.25\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e40.79\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.01\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.100\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e\\u003cp\\u003eDuration of infertility\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e4.37\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.86\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e4.97\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.87\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.361\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e\\u003cp\\u003eantral follicle count(AFC)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e3.87\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.84\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e3.44\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.31\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.110\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e\\u003cp\\u003eNumber of follicles\\u0026thinsp;\\u0026gt;\\u0026thinsp;14mm on HCG day\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e2.18\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.09\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e1.75\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.75\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.007*\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e\\u003cp\\u003eMean number of oocyte obtained\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e2.24\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.60\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e1.77\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.16\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.004*\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eProtocols\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eGnRH antagonist protocol\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e64/153 (41.83)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e59/124 (47.58)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e0.061\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eminimal stimulation protocol\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e58/153 (37.91)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e31/124 (25.00)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003enatural cycle protocol\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e14/153 (9.15)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e21/124 (16.94)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eOther protocols\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e17/153 (11.11)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e13/124 (10.48)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\\u003cp\\u003eValues are presented as mean\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;standard deviation; BMI, body mass index; AMH, anti-M\\u0026uuml;llerian hormone; FSH, follicle stimulating hormone; AFC, Antral Follicle Count\\u003c/p\\u003e\\u003cp\\u003eThe percentage of oocyte-obtaining cycles in D-LN Group was higher than that in S-LN Group (91.94% vs. 86.93%), but the difference was not statistically significant (\\u003cem\\u003eP\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.182), and the differences in the overall ORR, normal fertilization rate, usable embryo rate, and high-quality embryo rate of the two methods of oocyte retrieval were not statistically significant. (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e)\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eLaboratory cultivation parameters between two groups\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"4\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eVariable\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eS-LN Group\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eD-LN Group\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eP-value\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003ePercentage of oocyte-obtained cycles (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e133/153 (86.93)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e114/124 (91.94)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.182\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eoocyte retrieval rate (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e343/489 (70.14)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e219/311 (70.42)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.934\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eNormal fertilization rate (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e221/334 (66.17)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e132/211 (62.56)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.390\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eRate of available embryos (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e200/229 (87.34)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e122/138 (88.41)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.762\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003ehigh-quality embryo rate (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e78/218 (35.78)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e51/126 (40.48)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.386\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\\u003cp\\u003eLive birth rate of embryo transfer in the two groups a total of 90 cycles of S-LN were transferred, of which 32 were fresh transfer cycles and 58 were frozen embryo transfer cycles, and a total of 50 cycles of D-LN were transferred, of which 19 were fresh transfer cycles and 31 were frozen embryo transfer cycles. (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab3\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eLive birth rates of embryo transfer between two groups\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"7\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eVariable\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eS-LN Group fresh ET\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eD-LN Group fresh ET\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eP-value\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003eS-LN Group FET\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003eD-LN Group FET\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003eP-value\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eTotal number of cycles\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e32\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e19\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e58\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e31\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eClinical pregnancy rate (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e4/32 (12.50)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e4/19 (21.05)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.450\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e11/54(20.37)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e7/31 (22.58)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e0.810\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eabortion rate (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e1/4 (25.00)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e6/11 (54.55)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e2/7 (28.57)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e0.367\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003elive birth rate (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e3/32 (9.38)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e4/19 (21.05)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.402\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e5/58 (8.62)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u003cp\\u003e5/31 (16.13)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003e0.285\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003ctfoot\\u003e\\u003ctr\\u003e\\u003ctd colspan=\\\"7\\\"\\u003eET, embryo transfer; FET, frozen embryo transfer\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tfoot\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\\u003cp\\u003eA total of 70 patients were included in this study, of which 27 patients had embryos that were not fully thawed or embryos that had been discarded from the oocyte retrieval cycle, and 43 patients had all their embryos utilized (8 thawed with a mixture of single and double lumen needle embryos), so only the cumulative live birth rates of these 35 patients will be discussed in this study. (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab4\\\" class=\\\"InternalRef\\\"\\u003e4\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab4\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 4\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eCumulative live birth rate between two groups\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"4\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eVariable\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003eS-LN Group\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eD-LN Group\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003eP-value\\u003c/p\\u003e\\u003c/th\\u003e\\u003c/tr\\u003e\\u003c/thead\\u003e\\u003ctbody\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eNumber of fresh transplant cycles\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e17\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e9\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eclinical pregnancy rate (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e3/17 (17.65)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e3/9 (33.33)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.669\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eabortion rate (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e1/3 (33.33)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eNumber of cycles of frozen embryo transfer\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e24\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e23\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eClinical pregnancy rate(%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e2/24 (8.3)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e3/23 (13.04)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.666\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eabortion rate (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e0\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eCumulative pregnancy rate (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e5/41 (12.20)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e6/32 (18.75)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.437\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eCumulative live birth rate (%)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e4/41 (9.76)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003e6/32 (18.75)\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e0.271\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eOocyte retrieval is one of the key steps in assisted reproduction. [\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e] Obtaining a satisfactory number of oocytes is a prerequisite for a series of subsequent embryo cultures and embryo transfers, and how to maximize the rate of oocyte retrieval in patients with fewer follicles is a difficult problem that needs to be pondered. With the development of ART, double lumen needles are gradually being used for oocyte retrieval in clinical practice, which can be used to pump follicular fluid while injecting culture fluid to rinse the inner wall of the follicle directly, and to minimize the residual of oocytes, especially for those oocytes that are deeply located or tightly adhered to the follicular wall.\\u003c/p\\u003e\\u003cp\\u003eOur center is gradually promoting the use of double lumen needles after 2021 in patients with few follicles (patients with 1\\u0026ndash;5 follicles with a diameter of 14 mm or more follicles on the trigger day), who have difficulty in obtaining live births in a single oocyte retrieval cycle due to the low number of oocyte acquired and the difficulty in the formation of viable embryos. In order to accumulate embryos, several cycles of ovulation induction are experienced. In this study, a before-and-after controlled analysis of such patients was performed, including all cycles of oocyte retrieval, and analyzing the cultured embryos and the clinical outcome according to the oocyte retrieval and puncture needles used registered on the day of the procedure. The present study included the number of all cycles of oocyte retrieval from January 2019 to December 2024 in 70 patients, who had a total of 277 cycles of oocyte retrieval (of which the group using single-lumen needle 153 cycles and 124 cycles in the group using double lumen needle), experiencing at least one single lumen needle oocyte retrieval, one double lumen needle oocyte retrieval, or even multiple oocyte retrievals, with number of oocyte retrieved, fertilization, eugenic embryos, and available embryos expressed as percentages, and an overall assessment of whether or not the use of double lumen needle oocyte retrieval results in a clinical outcome similar to that of the single lumen needle as patients' age at oocyte retrieval increases and their ovarian reserve function decreases, although the the number of follicles\\u0026thinsp;\\u003cb\\u003e\\u0026gt;\\u003c/b\\u003e\\u0026thinsp;14 mm on HCG days 、AMH and the mean number of oocyte obtained in the group using double lumen needle were significantly lower than that in the group using single lumen needle oocyte retrieval, and the difference was statistically significant, but when analyzing the cumulative live birth rate, we found that although the age of the group using double lumen needle increased and the ovarian function declined, the cumulative pregnancy rate and cumulative live birth rate obtained were comparable to the results of the group using single lumen needle.\\u003c/p\\u003e\\u003cp\\u003eOne RCT study concluded that using a double-lumen needle during oocyte retrieval in patients with single follicular development, the oocyte retrieval rate was only 25%, and the oocyte retrieval rate could be increased to 83% after five rinses, repeated rinses did not affect the oocyte maturation rate or embryo quality; [\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e] One study concluded that double-lumen needle could increase the oocyte retrieval rate and maturation rate in patients with single follicular development. [\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e] Two prospective controlled studies concluded that using double lumen needles in poorly responding patients resulted in a lower rate of oocyte retrieval and prolonged procedure time. [\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e] A Cochrane review concluded that for both poorly responding and normally responding patients, oocyte retrieval using double lumen needles had no benefit. [\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e] Many scholars have studied the efficacy after using single and double lumen needle oocyte retrieval, but the total population included was based on the population with no difference in baseline data, and one of the more prominent strengths of this study is that it included the same population using single and double lumen needles, and this group of patients were all experiencing at least one or more single and double lumen needle oocyte retrieval, which firstly eliminated the influence on the study outcome due to individual patient differences, and reduced the study's confounding factors. In patients with reduced ovarian function, it is often difficult to achieve the goal of live birth with a single oocyte retrieval. When analyzing live births, this study analyzed the live births of fresh embryo transfer and frozen embryo transfer in both the single and double lumen groups and did a comparison of the cumulative live birth rates of the two methods of oocyte retrieval, and found that under the premise that the underlying AFC were similar in the two groups, even though there was an increase in the age of oocyte retrieval and a decline in ovarian function the percentage of oocyte-obtained cycles was increased in the double-lumen needle group compared with that in the group using a single lumen needle and the rate of normal fertilization, high-quality embryo rate, cumulative pregnancy rate and cumulative live birth rate were similar, suggesting that the use of double lumen needle is more beneficial to the patients in case of increasing age and declining ovarian function.\\u003c/p\\u003e\\u003cp\\u003eOocyte retrieval rate is one of the most important factors affecting the live birth rate in assisted reproduction, especially in women with fewer follicles, where one more precious oocyte may result in one more chance of embryo transfer. [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e] In this group of patients, who usually undergo more than one ovarian stimulation cycle, if the oocyte retrieval rate can be improved through the use of the double lumen needle technique in each oocyte retrieval procedure, the financial and psychological pressure on the patient will be greatly reduced.\\u003c/p\\u003e\\u003cp\\u003eThe limitations of this study are that it is a retrospective study, the fertilization method of the two populations is mainly IVF, and it is not possible to visually compare the rate of oocyte degeneration on the day of oocyte retrieval, and it is not possible to analyze whether the use of multiple rinses with a double-lumen needle for oocyte retrieval leads to an increase in the rate of degeneration.\\u003c/p\\u003e\\u003cp\\u003eIn conclusion, this study concluded that for the same patient, by using double lumen needle ovulation after versus before using single lumen needle ovulation, it was found that there was a tendency to increase the oocyte retrieval rate and the percentage of oocyte-obtained cycles with increasing age of the female partner, prolonged years of infertility, and further decline in ovarian reserve, suggesting the necessity of using double lumen needle ovulation in patients with poor ovarian reserve. In the future, it is hoped that more cases will be included to analyze whether the use of double-lumen needle oocyte retrieval is beneficial in patients with poor ovarian response to increase the chances of implantation, and to increase the rate of live births.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003ch2\\u003eAuthor Contribution\\u003c/h2\\u003e\\u003cp\\u003eXiaoxia Zhang: Conceptualization, Data curation, Writing-original draft Li Sun: Data curationJianping Ou: MethodologyShuqi Ge: Supervision, Writing-review \\u0026amp; editing\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eGembruch U, Diedrich K, Welker B, et al.\\u0026zwnj; Transvaginal sonographically guided oocyte retrieval for in-vitro fertilization. Hum Reprod. 1988;3(Suppl 2):59\\u0026ndash;63. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1093/oxfordjournals.humrep.a136799\\u003c/span\\u003e\\u003cspan address=\\\"10.1093/oxfordjournals.humrep.a136799\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eLudwig AK, Glawatz M, Griesinger G, et al.\\u0026zwnj; Perioperative complications of transvaginal ultrasound-guided oocyte retrieval Hum Reprod. 2006;21(12):3235\\u0026ndash;3240. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1093/humrep/del278\\u003c/span\\u003e\\u003cspan address=\\\"10.1093/humrep/del278\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eIainas G, Iainas T, Kolibianakis E.\\u0026zwnj; The importance of follicular flushing in optimizing oocyte retrieval. Curr Opin Obstet Gynecol. 2023;35(3):238\\u0026ndash;245. DOI:\\u0026zwnj; 10.1097/GCO.0000000000000868\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eNakagawa K, Nishi Y, Kaneyama M, et al.\\u0026zwnj; Newly designed needle reduces pain during single-follicle oocyte retrieval. J Reprod Infertil. 2015;16(4):207\\u0026ndash;211. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.18502/jri.v16i4.2143\\u003c/span\\u003e\\u003cspan address=\\\"10.18502/jri.v16i4.2143\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eYi Y, Fu J, Xie S, et al.\\u0026zwnj; Ovarian reserve and spontaneous miscarriage: shared genetic architecture. Hum Reprod. 2023;\\u003cem\\u003e38\\u003c/em\\u003e(\\u003cem\\u003e11\\u003c/em\\u003e):\\u003cem\\u003e2247\\u0026ndash;2258\\u003c/em\\u003e. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1093/humrep/dead181\\u003c/span\\u003e\\u003cspan address=\\\"10.1093/humrep/dead181\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eBusnelli A, Somigliana E, Cirillo F, et al.\\u0026zwnj; Diminished ovarian reserve as miscarriage risk factor: meta-analysis. Hum Reprod Update. 2021;\\u003cem\\u003e27\\u003c/em\\u003e(\\u003cem\\u003e6\\u003c/em\\u003e):\\u003cem\\u003e973\\u0026ndash;988\\u003c/em\\u003e. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1093/humupd/dmab021\\u003c/span\\u003e\\u003cspan address=\\\"10.1093/humupd/dmab021\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eRonchetti C, Cirillo F, Immediata V, et al.\\u0026zwnj; RCT comparing single/double-lumen needles in ART \\u003cem\\u003eReprod Sci.\\u003c/em\\u003e 2023;\\u003cem\\u003e30\\u003c/em\\u003e(\\u003cem\\u003e9\\u003c/em\\u003e):\\u003cem\\u003e2866\\u0026ndash;2875\\u003c/em\\u003e. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1007/s43032-023-01239-3\\u003c/span\\u003e\\u003cspan address=\\\"10.1007/s43032-023-01239-3\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eCimpeanu R, Castrej\\u0026oacute;n-Pita AA, Lim LN, et al.\\u0026zwnj; Flow-based design for double-lumen needles J Biomech. 2023; 160:111832. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.jbiomech.2023.111832\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.jbiomech.2023.111832\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eMaldonado Rosas I, Anagnostopoulou C, Singh N, et al.\\u0026zwnj; Optimizing oocyte retrieval and embryo transfer techniques Panminerva Med. 2022;64(2):156\\u0026ndash;170. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.23736/S0031-0808.21.04508-3\\u003c/span\\u003e\\u003cspan address=\\\"10.23736/S0031-0808.21.04508-3\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eKohl Schwartz AS, Calzaferri I, Roumet M, et al.\\u0026zwnj; Follicular flushing increases oocyte yield in monofollicular IVF: RCT Hum Reprod. 2020;35(10):2253\\u0026ndash;2261. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1093/humrep/deaa186\\u003c/span\\u003e\\u003cspan address=\\\"10.1093/humrep/deaa186\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003ePabuccu EG, Arslanca T, Ucar U, et al.\\u0026zwnj; Double-lumen needle benefits mono-follicular poor responders J Gynecol Obstet Hum Reprod. 2021;50(9):102150. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.jogoh.2021.102150\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.jogoh.2021.102150\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eCalabre C, Schuller E, Goltzene MA, et al.\\u0026zwnj; Follicular flushing vs direct aspiration in poor responders: RCT. Eur J Obstet Gynecol Reprod Biol. 2020;248:118\\u0026ndash;122. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.ejogrb.2020.03.023\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.ejogrb.2020.03.023\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eSouza MM, Mancebo ACA, Souza MDCB, et al.\\u0026zwnj; Evaluation of follicular flushing with double-lumen needle in ART. JBRA Assist Reprod. 2021;\\u003cem\\u003e25\\u003c/em\\u003e(\\u003cem\\u003e2\\u003c/em\\u003e):\\u003cem\\u003e272\\u0026ndash;275\\u003c/em\\u003e. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.5935/1518-0557.20210003\\u003c/span\\u003e\\u003cspan address=\\\"10.5935/1518-0557.20210003\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eGeorgiou EX, Melo P, Brown J, et al.\\u0026zwnj; Cochrane review: follicular flushing during oocyte retrieval. Cochrane Database Syst Rev. 2018;4(4):CD004634. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1002/14651858.CD004634.pub3\\u003c/span\\u003e\\u003cspan address=\\\"10.1002/14651858.CD004634.pub3\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eJamil M, Debbarh H, Kabit A, et al.\\u0026zwnj; Impact of oocyte number on IVF outcomes. Zygote. 2023;31(1):91\\u0026ndash;96. DOI:\\u0026zwnj; 10.1017/S0967199422000482\\u003c/span\\u003e\\u003c/li\\u003e\\u003cli\\u003e\\u003cspan\\u003eMagnusson \\u0026Aring;, K\\u0026auml;llen K, Thurin-Kjellberg A, et al.\\u0026zwnj; Oocyte retrieval number: balancing efficacy and safety. Hum Reprod. 2018;33(1):58\\u0026ndash;64. DOI:\\u0026zwnj; \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1093/humrep/dex334\\u003c/span\\u003e\\u003cspan address=\\\"10.1093/humrep/dex334\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"double-lumen needle oocyte retrieval, diminished ovarian reserve, assisted reproductive technology, oocyte retrieval rate, Embryo Transfer‌\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-6975589/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-6975589/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003ch2\\u003ePurpose\\u003c/h2\\u003e\\u003cp\\u003eWe investigate the clinical value of double-lumen needle oocyte retrieval in patients with diminished ovarian reserve (DOR) undergoing in vitro fertilization-embryo transfer (IVF-ET), and to analyze its effects on oocyte retrieval rate, embryo quality, and pregnancy outcomes.\\u003c/p\\u003e\\u003ch2\\u003eMethods\\u003c/h2\\u003e\\u003cp\\u003eThis single-center retrospective cohort study analyzed data from 70 patients undergoing 277 oocyte retrieval cycles over a 5-year period (153 cycles with single-lumen needles versus 124 with double-lumen needles). Comprehensive comparisons were made between the two groups regarding embryological parameters (fertilization rates, embryo quality) and clinical outcomes (implantation rates, pregnancy outcomes).\\u003c/p\\u003e\\u003ch2\\u003eResults\\u003c/h2\\u003e\\u003cp\\u003eFor the same cohort of patients, despite increased age and decreased Anti-M\\u0026uuml;llerian Hormone (AMH) levels at the time of oocyte retrieval using double-lumen needle, the percentage of oocyte-obtained cycles showed a non-significant trend toward improvement with double-lumen needles compared to single-lumen needles (91.94% vs 86.93%, p\\u0026thinsp;=\\u0026thinsp;0.182). The rates of oocyte retrieval, day 3 good-quality embryos, clinical pregnancy, implantation and live birth, and the cumulative live birth, no statistically significant differences between the two groups (all p\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.05).\\u003c/p\\u003e\\u003ch2\\u003eConclusions\\u003c/h2\\u003e\\u003cp\\u003eIn the same patient cohort, \\u0026zwnj;despite advancing oocyte retrieval age, prolonged duration of infertility, and declining ovarian reserve function\\u0026zwnj;, double-lumen needle oocyte retrieval achieved \\u0026zwnj;comparable embryo culture outcomes\\u0026zwnj; and \\u0026zwnj;equivalent clinical outcomes\\u0026zwnj; to single-lumen needle retrieval.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Comparison of cumulative live birth rates between oocyte retrieval using single-lumen and double-lumen needles: a self-controlled retrospective cohort study\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2025-09-03 18:59:09\",\"doi\":\"10.21203/rs.3.rs-6975589/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"8de1a81a-d30d-472e-8c41-8e88c2625d18\",\"owner\":[],\"postedDate\":\"September 3rd, 2025\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2025-10-29T10:53:18+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2025-09-03 18:59:09\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-6975589\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-6975589\",\"identity\":\"rs-6975589\",\"version\":[\"v1\"]},\"buildId\":\"8U1c8b4HqxoKbykW_rLl7\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}