A comparison of intravenous general anesthesia and paracervical block for in vitro fertilization: effects on oocytes using the transvaginal technique

Authors: SEVİL BÜMEN, İLKBEN GÜNÜŞEN, VİCDAN FIRAT, SEMRA KARAMAN, AYŞİN AKDOĞAN, EGE NAZAN TAVMERGEN GÖKER

Abstract: To compare the effects of 2 different anesthetic techniques used for oocyte retrieval. Comparison was made based on the number of retrieved and fertilized oocytes, metaphase 2 (M2, mature) oocytes, and transferred embryos, as well as fertilization, pregnancy, and live birth rates. Ultrasound-guided transvaginal oocyte retrieval for in vitro fertilization is one of the most common minor surgical procedures. Despite this, it is stressful and painful for the patient; most patients request sedation and/or pain relief. Propofol, which is frequently used for general anesthesia in such procedures, has been suspected to damage oocytes. Materials and methods: Results from 70 patients without premedication were compared in this randomized prospective study. Patients were divided into 2 groups based on treatment. Those in Group G received intravenous general anesthesia with atropine (10 \mug kg^{-1}), remifentanil (1 \mug kg^{-1}), and propofol (2.5 mg kg^{-1}), while patients in Group P received a paracervical block with 100 mg of prilocaine (2%) and 0.75 mg kg^{-1} of intramuscular meperidine. Results: Our results revealed no statistically significant difference between the 2 groups in terms of the fertilization rate. The numbers of retrieved and mature oocytes and transferred embryos and the pregnancy rate were greater in the general anesthesia group, although only the number of transferred embryos showed a statistically significant difference (P = 0.045). Conclusion: According to our data, both anesthesia techniques can be used for oocyte retrieval since there were no differences in fertilization, pregnancy, or live birth rates between the 2 groups.

Keywords: General anesthesia, paracervical block, oocyte, fertilization rate, pregnancy

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