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Published in: Journal of Assisted Reproduction and Genetics 11/2017

01-11-2017 | Assisted Reproduction Technologies

IVF oocyte retrieval: prospective evaluation of the type of anesthesia on live birth rate, pain, and patient satisfaction

Authors: Lucie Rolland, Jeanne Perrin, Virginie Villes, Valérie Pellegrin, Léon Boubli, Blandine Courbiere

Published in: Journal of Assisted Reproduction and Genetics | Issue 11/2017

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Abstract

Purpose

Does the type of anesthesia (paracervical block (PCB) or general anesthesia (GA)) impact live birth rate, pain, and patient satisfaction?

Methods

A non-randomized prospective cohort study was conducted in women treated for IVF. Two groups of patients were prospectively included: the PCB group (n = 234) and the GA group (n = 247). The type of anesthesia was determined by the patients. The primary endpoint was cumulative live birth rate by OR. Secondary endpoints were self-assessment of the patients’ peri-operative abdominal and vaginal pain vs the doctors’ evaluations during PCB, post-operative abdominal and vaginal pain level, and patient satisfaction in both groups. Pain levels were assessed with a numerical rating scale (NRS).

Results

The live birth rate was similar in both groups (19.8% in the GA group vs 20.9% in the PCB group, P = 0.764). During oocyte retrieval in the PCB group, the physicians significantly under-estimated the vaginal pain experienced by the patients (3.04 ± 0.173 for patients vs 2.59 ± 0.113 for surgeons, P = 0.014). Post-operative vaginal and abdominal pain were significantly greater in the PCB group compared to the GA group (2.26 ± 0.159 vs 1.66 ± 0.123, respectively, P = 0.005, and 3.80 ± 0.165 vs 3.00 ± 0.148, respectively, P < 0.001). Patients were more significantly satisfied with GA than with PBC (P < 0.001).

Conclusion

Because the LBR was similar in both groups and patient satisfaction was high, the choice of anesthesia should be decided by the patients.
Literature
1.
go back to reference Wikland M, Enk L, Hamberger L. Transvesical and transvaginal approaches for the aspiration of follicles by use of ultrasound. Ann N Y Acad Sci. 1985;442:182–94.CrossRefPubMed Wikland M, Enk L, Hamberger L. Transvesical and transvaginal approaches for the aspiration of follicles by use of ultrasound. Ann N Y Acad Sci. 1985;442:182–94.CrossRefPubMed
2.
go back to reference Vlahos NF, Giannakikou I, Vlachos A, Vitoratos N. Analgesia and anesthesia for assisted reproductive technologies. Int J Gynecol Obstet. 2009;105:201–5.CrossRef Vlahos NF, Giannakikou I, Vlachos A, Vitoratos N. Analgesia and anesthesia for assisted reproductive technologies. Int J Gynecol Obstet. 2009;105:201–5.CrossRef
3.
go back to reference Kim WO, Kil HK, Koh SO, Kim JI. Effects of general and locoregional anesthesia on reproductive outcome for in vitro fertilization: a meta-analysis. J Korean Med Sci. 2000;15:68.CrossRefPubMedPubMedCentral Kim WO, Kil HK, Koh SO, Kim JI. Effects of general and locoregional anesthesia on reproductive outcome for in vitro fertilization: a meta-analysis. J Korean Med Sci. 2000;15:68.CrossRefPubMedPubMedCentral
4.
go back to reference Koninckx PR, Renaer M. Pain sensitivity of and pain radiation from the internal female genital organs. Hum Reprod. 1997;12:1785–8.CrossRefPubMed Koninckx PR, Renaer M. Pain sensitivity of and pain radiation from the internal female genital organs. Hum Reprod. 1997;12:1785–8.CrossRefPubMed
5.
go back to reference Ng EHY, Tang OS, Chui DKC, Ho PC. A prospective, randomized, double-blind and placebo-controlled study to assess the efficacy of paracervical block in the pain relief during egg collection in IVF. Hum Reprod. 1999;14:2783–7.CrossRefPubMed Ng EHY, Tang OS, Chui DKC, Ho PC. A prospective, randomized, double-blind and placebo-controlled study to assess the efficacy of paracervical block in the pain relief during egg collection in IVF. Hum Reprod. 1999;14:2783–7.CrossRefPubMed
7.
go back to reference Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP). Arthritis Care Res. 2011;63:S240–52.CrossRef Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP). Arthritis Care Res. 2011;63:S240–52.CrossRef
8.
go back to reference Bourdel N, Alves J, Pickering G, Ramilo I, Roman H, Canis M. Systematic review of endometriosis pain assessment: how to choose a scale? Hum Reprod Update. 2015;21:136–52.CrossRefPubMed Bourdel N, Alves J, Pickering G, Ramilo I, Roman H, Canis M. Systematic review of endometriosis pain assessment: how to choose a scale? Hum Reprod Update. 2015;21:136–52.CrossRefPubMed
9.
go back to reference Bümen S, Günüşen İ, Firat V, Karaman S, Akdoğan A, Göker ENT. A comparison of intravenous general anesthesia and paracervical block for in vitro fertilization: effects on oocytes using the transvaginal technique. Turk J Med Sci. 2011;41:801–8. Bümen S, Günüşen İ, Firat V, Karaman S, Akdoğan A, Göker ENT. A comparison of intravenous general anesthesia and paracervical block for in vitro fertilization: effects on oocytes using the transvaginal technique. Turk J Med Sci. 2011;41:801–8.
10.
go back to reference Christiaens F, Janssenswillen C, Steirteghem ACV, Devroey P, Verborgh C, Camu F. Comparison of assisted reproductive technology performance after oocyte retrieval under general anaesthesia (propofol) versus paracervical local anaesthetic block: a case-controlled study. Hum Reprod. 1998;13:2456–60.CrossRefPubMed Christiaens F, Janssenswillen C, Steirteghem ACV, Devroey P, Verborgh C, Camu F. Comparison of assisted reproductive technology performance after oocyte retrieval under general anaesthesia (propofol) versus paracervical local anaesthetic block: a case-controlled study. Hum Reprod. 1998;13:2456–60.CrossRefPubMed
11.
go back to reference Hammadeh ME, Wilhelm W, Huppert A, Rosenbaum P, Schmidt W. Effects of general anaesthesia vs. sedation on fertilization, cleavage and pregnancy rates in an IVF program. Arch Gynecol Obstet. 1999;263:56–9.CrossRefPubMed Hammadeh ME, Wilhelm W, Huppert A, Rosenbaum P, Schmidt W. Effects of general anaesthesia vs. sedation on fertilization, cleavage and pregnancy rates in an IVF program. Arch Gynecol Obstet. 1999;263:56–9.CrossRefPubMed
12.
go back to reference Tummon I, Newton C, Lee C, Martin J. Lidocaine vaginal gel versus lidocaine paracervical block for analgesia during oocyte retrieval. Hum Reprod. 2004;19:1116–20.CrossRefPubMed Tummon I, Newton C, Lee C, Martin J. Lidocaine vaginal gel versus lidocaine paracervical block for analgesia during oocyte retrieval. Hum Reprod. 2004;19:1116–20.CrossRefPubMed
13.
go back to reference Egan B, Racowsky C, Hornstein MD, Martin R, Tsen LC. Anesthetic impact of body mass index in patients undergoing assisted reproductive technologies. J Clin Anesth. 2008;20:356–63.CrossRefPubMed Egan B, Racowsky C, Hornstein MD, Martin R, Tsen LC. Anesthetic impact of body mass index in patients undergoing assisted reproductive technologies. J Clin Anesth. 2008;20:356–63.CrossRefPubMed
14.
go back to reference Ng EHY, Miao B, Ho PC. Anxiolytic premedication reduces preoperative anxiety and pain during oocyte retrieval. A randomized double-blinded placebo-controlled trial. Hum Reprod. 2002;17:1233–8.CrossRefPubMed Ng EHY, Miao B, Ho PC. Anxiolytic premedication reduces preoperative anxiety and pain during oocyte retrieval. A randomized double-blinded placebo-controlled trial. Hum Reprod. 2002;17:1233–8.CrossRefPubMed
15.
go back to reference Cerne A, Bergh C, Borg K, Ek I, Gejervall A-L, Hillensjö T, et al. Pre-ovarian block versus paracervical block for oocyte retrieval. Hum Reprod. 2006;21:2916–21.CrossRefPubMed Cerne A, Bergh C, Borg K, Ek I, Gejervall A-L, Hillensjö T, et al. Pre-ovarian block versus paracervical block for oocyte retrieval. Hum Reprod. 2006;21:2916–21.CrossRefPubMed
16.
go back to reference Frederiksen Y, Mehlsen MY, Matthiesen SMS, Zachariae R, Ingerslev HJ. Predictors of pain during oocyte retrieval. J Psychosom Obstet Gynaecol. 2017;38:21–9.CrossRefPubMed Frederiksen Y, Mehlsen MY, Matthiesen SMS, Zachariae R, Ingerslev HJ. Predictors of pain during oocyte retrieval. J Psychosom Obstet Gynaecol. 2017;38:21–9.CrossRefPubMed
17.
go back to reference Ng EHY, Chui DKC, Tang OS, Ho PC. Paracervical block with and without conscious sedation: a comparison of the pain levels during egg collection and the postoperative side effects. Fertil Steril. 2001;75:711–7.CrossRefPubMed Ng EHY, Chui DKC, Tang OS, Ho PC. Paracervical block with and without conscious sedation: a comparison of the pain levels during egg collection and the postoperative side effects. Fertil Steril. 2001;75:711–7.CrossRefPubMed
18.
go back to reference Ben-Shlomo I, Moskovich R, Katz Y, Shalev E. Midazolam/ketamine sedative combination compared with fentanyl/propofol/isoflurane anaesthesia for oocyte retrieval. Hum Reprod. 1999;14:1757–9.CrossRefPubMed Ben-Shlomo I, Moskovich R, Katz Y, Shalev E. Midazolam/ketamine sedative combination compared with fentanyl/propofol/isoflurane anaesthesia for oocyte retrieval. Hum Reprod. 1999;14:1757–9.CrossRefPubMed
19.
go back to reference Casati A, Valentini G, Zangrillo A, Senatore R, Mello A, Airaghi B, et al. Anaesthesia for ultrasound guided oocyte retrieval: midazolam/remifentanil versus propofol/fentanyl regimens. Eur J Anaesthesiol. 1999;16:773–8.CrossRefPubMed Casati A, Valentini G, Zangrillo A, Senatore R, Mello A, Airaghi B, et al. Anaesthesia for ultrasound guided oocyte retrieval: midazolam/remifentanil versus propofol/fentanyl regimens. Eur J Anaesthesiol. 1999;16:773–8.CrossRefPubMed
20.
go back to reference Guasch E, Ardoy M, Cuadrado C, González Gancedo P, González A, Gilsanz F. Comparison of 4 anesthetic techniques for in vitro fertilization. Rev Esp Anestesiol Reanim. 2005;52:9–18.PubMed Guasch E, Ardoy M, Cuadrado C, González Gancedo P, González A, Gilsanz F. Comparison of 4 anesthetic techniques for in vitro fertilization. Rev Esp Anestesiol Reanim. 2005;52:9–18.PubMed
21.
go back to reference Trout SW, Hazard VA, Kemmann E. Conscious sedation for in vitro fertilization. Fertil Steril. 1998;69:799–808.CrossRefPubMed Trout SW, Hazard VA, Kemmann E. Conscious sedation for in vitro fertilization. Fertil Steril. 1998;69:799–808.CrossRefPubMed
22.
go back to reference Gohar J, Lunenfeld E, Potashnik G, Glezerman M. The use of sedation only during oocyte retrieval for in vitro fertilization: patients’ pain self-assessments versus doctors’ evaluations. J Assist Reprod Genet. 1993;10:476–8.CrossRefPubMed Gohar J, Lunenfeld E, Potashnik G, Glezerman M. The use of sedation only during oocyte retrieval for in vitro fertilization: patients’ pain self-assessments versus doctors’ evaluations. J Assist Reprod Genet. 1993;10:476–8.CrossRefPubMed
Metadata
Title
IVF oocyte retrieval: prospective evaluation of the type of anesthesia on live birth rate, pain, and patient satisfaction
Authors
Lucie Rolland
Jeanne Perrin
Virginie Villes
Valérie Pellegrin
Léon Boubli
Blandine Courbiere
Publication date
01-11-2017
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 11/2017
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-017-1002-7

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