Epidural anesthesia in an in vitro fertilization and embryo transfer program.
OBJECTIVE
To investigate the potential advantages of epidural anesthesia in an in vitro fertilization and embryo transfer program.


METHODS
Between January 1991 and December 1992, 148 infertile patients underwent transvaginal ultrasound guided oocyte retrieval. A total of 44 patients (group A) had 50 retrievals under epidural anesthesia, and 104 patients (group B, control group) 112 retrievals under intravenous sedation (propofol) with mask-assisted ventilation (nitrous oxide).


RESULTS
In group A satisfactory anesthesia was achieved in 49 of the 50 cases (98%); one patient required additional intravenous administration of propofol owing to extreme anxiety. No complications were observed. Adversely, in group B nausea was observed in 16 cases (14%) and nausea and vomiting in 7 cases (6%). In group A the fertilization, cleavage and pregnancy rates were 67.2%, 92% and 20% respectively, while in group B the rates were 69.3%, 93% and 19.6% respectively; the differences are not statistically significant.


CONCLUSIONS
Epidural anesthesia is an effective method for transvaginal oocyte retrieval but does not improve the treatment outcome as compared to an intravenous sedation with mask-assisted ventilation using propofol and nitrous oxide.
Ecocenter and Fertility Center, Clinica C. G. Ruesch, Napoli, Italy.
G
G
Botta
A
A
D'Angelo
G
G
D'Ari
G
G
Merlino
M
M
Chapman
G
G
Grudzinskas
D000280:Administration, Inhalation; D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000773:Anesthesia, Obstetrical; D018686:Anesthetics, Intravenous; D004624:Embryo Transfer; D005314:Embryonic and Fetal Development / Q000502:physiology; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007275:Injections, Intravenous; D009325:Nausea / Q000139:chemically induced; D009609:Nitrous Oxide; D018587:Oocyte Donation / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D015742:Propofol; D014839:Vomiting / Q000139:chemically induced
D018686:Anesthetics, Intravenous; D009609:Nitrous Oxide; D015742:Propofol