Comparison of Cumulative Live Birth Rates Between Oocyte Retrieval Using Single-Lumen and Double-Lumen Needles: A Retrospective Cohort Study

Background: Diminished ovarian reserve (DOR) is associated with suboptimal oocyte retrieval efficiency during in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI), and conventional single-lumen needle (S-LN) aspiration presents inherent limitations that may further compromise outcomes in this patient population. Double-lumen needle (D-LN) aspiration has been proposed to enhance procedural precision; however, its clinical value in patients with DOR remains unconfirmed. Existing studies on oocyte retrieval techniques for DOR patients still lack high-quality comparative evidence to guide clinical practice optimization. This study aimed to compare the effects of double-lumen versus S-LN aspiration on oocyte yield, embryo quality, and pregnancy outcomes in DOR patients undergoing in vitro fertilization and embryo transfer (IVF-ET). Methods: A retrospective, self-controlled cohort study was conducted at a tertiary reproductive center over a 6-year period, enrolling 70 DOR patients who underwent a total of 277 oocyte retrieval cycles, of which 153 utilized S-LN and 124 utilized D-LN. Key embryological parameters (fertilization rate and embryo quality) and clinical outcomes (implantation and pregnancy rates) were compared between groups. Results: Patients undergoing D-LN retrieval were significantly older, had a longer duration of infertility, and presented with lower anti-Müllerian hormone (AMH) levels compared with the single-lumen group. Although the proportion of successful retrieval cycles was numerically higher in the double-lumen group (91.94% vs. 86.93%, p = 0.182), this difference did not reach statistical significance. ‌The S-LN method was linked to a significantly greater oocyte yield than the D-LN method (B = 0.200, p = 0.009) in the generalized estimating equations (GEE) model adjusted for within-patient clustering, age, AMH, BMI, and protocol, the two methods remained comparable in terms of number of day-3 high-quality embryos, clinical pregnancy rate, implantation rate, live birth rate, and cumulative live birth rate (all p > 0.05). Conclusions: In the same patient cohort, despite advancing oocyte retrieval age, prolonged duration of infertility, and declining ovarian reserve function, D-LN oocyte retrieval yielded comparable embryo culture outcomes and equivalent clinical outcomes to S-LN retrieval.