Objectives: To evaluate the endometrial thickness, implantation rate, and clinical pregnancy rates as results of intrauterine flushing during the ICSI cycle using granulosa cells and follicular fluid.
Methods: The Cochrane Library, MEDLINE, PubMed, Web of Science, Google Scholar, and Embase databases were thoroughly searched up till June 2024, in order to find relevant papers. Follicular fluid flushing of the endometrial cavity was employed in six randomized controlled trials to enhance IVF/ICSI cycle results.
Results: There is no statistical difference between the two cohorts as regards endometrial thickness, the summarized standardized mean difference (SMD) is 0.08 with a 95% confidence interval of (0.1 - 0.25). There is also no statistical difference between the two cohorts as regards implantation rate, the overall risk ratio is 0.95 with a 95% confidence interval of (0.69 - 1.3). And finally, there is no statistical difference between the two cohorts as regards clinical pregnancy rate, the overall risk ratio is 0.99 with a 95% confidence interval of (0.83 - 1.18). The test for overall effect for all outcomes does not show a significant effect.
Conclusion: It is crucial to stress that Follicular Fluid should be used extremely carefully, as it seems that flushing it into the endometrial cavity had no influence on endometrial thickness, clinical pregnancy or implantation rates, either favorably or unfavorably.