[The effect of different anesthetic procedures on hormone levels in women. Studies during an in vitro fertilization-embryo transfer (IVF-ET) program].
Different anaesthetic procedures that were used during an in vitro fertilisation and embryo transfer (IVF-ET) program have been analysed in order to determine their influence on plasma levels of estradiol, progesterone, prolactin, and beta-endorphin and results of IVF-ET. METHODS. Fifty-four patients awaiting transvaginal oocyte aspiration were randomised into three groups: (1) anaesthesia with ketamine as an induction agent and analgesic (n = 20); (2) general intubation anaesthesia using thiopentone for induction and enflurane for maintenance (n = 18); and (3) no anaesthesia (n = 16). Estradiol, progesterone, prolactin, and beta-endorphin were measured from day 3 to 14 referring to follicle aspiration. Differences between preoperative hormone levels and their intra- and postoperative peaks were analysed using the Kruskal-Wallis test (P < 0.03). The results were corrected using the Holms method (alpha = 0.05). RESULTS. No differences were observed in estradiol and progesterone levels (Figs. 1, 2). Prolactin levels were 1.4 times higher (P < 0.001) when ketamine was used and 2.2 times higher (P < 0.001) after short general anaesthesia than in the control group (Fig.3). Similar results were observed with respect to beta-endorphin: in comparison with the control group we found significant elevation by a factor of 2.1 when ketamine was used (P < 0.001). The discrepancy became even more marked with general anaesthesia: beta-endorphin was 3.9 times higher compared to the controls (P < 0.001) (Fig.4). Comparing the two groups who were given anaesthetics, prolactin and beta-endorphin levels were also significantly different (P < 0.001). The IVF procedure itself did not appear to be affected by different anaesthetic procedures during oocyte aspiration (Table 2). CONCLUSIONS. The increased prolactin and beta-endorphin plasma levels associated with ketamine and general anaesthesia reflect a significant alteration of the observed hormone levels. When anaesthesia is indicated, we try to avoid general intubation anaesthesia in favor of ketamine.
Universitätsfrauenklinik, Ulm.
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D000328:Adult; D000768:Anesthesia, General; D000777:Anesthetics / Q000494:pharmacology*; D004624:Embryo Transfer; D004737:Enflurane / Q000494:pharmacology; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D006728:Hormones / Q000097:blood*; D006801:Humans; D007649:Ketamine / Q000494:pharmacology; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D013874:Thiopental / Q000494:pharmacology; D001615:beta-Endorphin / Q000097:blood
D000777:Anesthetics; D006728:Hormones; D011374:Progesterone; D004958:Estradiol; D001615:beta-Endorphin; D007649:Ketamine; D011388:Prolactin; D004737:Enflurane; D013874:Thiopental
Der Einfluss unterschiedlicher Anästhesieverfahren auf den Hormonhaushalt der Frau. Untersuchungen im Rahmen eines in vitro-Fertilisations-Embryotransfer-(IVF-ET-)Programms.