title: General anesthesia versus monitored anesthesia care with remifentanil for assisted reproductive technologies: effect on pregnancy rate.
abstract: OBJECTIVE
  To compare the outcome of assisted reproductive technology procedures in women who undergo monitored anesthesia care (MAC) with remifentanil versus general anesthesia.
  
  
  METHODS
  Retrospective data analysis.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  251 ASA physical status I and II women participating in an in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) program.
  
  
  METHODS
  During the first phase of the study, all patients underwent general anesthesia induction with alfentanil, propofol, and nitrous oxide, which was maintained with isoflurane or propofol infusion. In the second phase of the study, all patients received a standardized MAC technique with a remifentanil infusion; local anesthetics were not used.
  
  
  METHODS
  The primary endpoint was pregnancy rate per transfer. The number of oocytes collected, fertilized, and cleaved was recorded, as was the number of oocytes transferred.
  
  
  RESULTS
  Patients who underwent MAC had a greater pregnancy rate with IVF (28.2 vs. 16.3%), with ICSI (32.2% vs. 18.8%), and overall (30.6% vs. 17.9%).
  
  
  CONCLUSIONS
  Pregnancy rates in women undergoing transvaginal oocyte retrieval for assisted reproductive technologies were significantly higher with a remifentanil-based MAC technique than with a general anesthetic technique.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, University of Saarland, Homburg/Saar, Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Wilhelm
authors.forename: Mohamad E
authors.initials: ME
authors.lastname: Hammadeh
authors.forename: Paul F
authors.initials: PF
authors.lastname: White
authors.forename: Thomas
authors.initials: T
authors.lastname: Georg
authors.forename: Rosine
authors.initials: R
authors.lastname: Fleser
authors.forename: Andreas
authors.initials: A
authors.lastname: Biedler
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D019162:Anesthetics, Combined; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007262:Infusions, Intravenous; D016343:Monitoring, Intraoperative; D009865:Oocytes; D010062:Ovulation Induction; D010880:Piperidines / Q000008:administration & dosage*; D011247:Pregnancy; D000077208:Remifentanil; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D020858:Tissue and Organ Harvesting; D018084:Ultrasonography, Interventional
chemical_list: D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D010880:Piperidines; D000077208:Remifentanil