title: Analgesia and anesthesia for assisted reproductive technologies.
abstract: BACKGROUND
  Oocyte retrieval for in vitro fertilization (IVF) is one of the most common minor surgical procedures.
  
  
  OBJECTIVE
  To give an update on anesthesia practices used currently in the United States and Europe in assisted reproductive technology, and discuss the safety or the potential risks for oocyte and embryo quality.
  
  
  METHODS
  Electronic search of MEDLINE for literature published between 1972 and 2008.
  
  
  METHODS
  Relevant studies on the types of anesthesia used for oocyte retrieval and the impact on oocyte and embryo quality.
  
  
  METHODS
  Relevant studies were reviewed by the authors and the ones of significant scientific merit, based on methodology, were included.
  
  
  RESULTS
  Types of anesthesia that may be used for transvaginal follicular aspiration and oocyte retrieval include: general anesthesia, neuraxial anesthesia, conscious sedation, injection of local anesthetic agents into the cervix or the vaginal wall, or any combination of the above. Conscious sedation is most commonly used in IVF because it is relatively safe and does not require the presence of an anesthesiologist when opioids or benzodiazepines are used. Propofol is the preferred anesthetic agent, but should be used by specially trained personnel.
  
  
  CONCLUSIONS
  Conscious sedation is the most popular method of anesthesia used in IVF. Presently, a combination of propofol, fentanyl, and midazolam is used frequently. It is easy to administer in cooperative and motivated patients and is safe in healthy individuals; it has a relatively low risk for adverse effects on oocyte and embryo quality and pregnancy rates.
authors.affiliation: Division of Reproductive Endocrinology, the Johns Hopkins Medical Institutions, Baltimore, MA, USA. nvlahos@jhmi.edu
authors.forename: Nikos F
authors.initials: NF
authors.lastname: Vlahos
authors.forename: Iosifina
authors.initials: I
authors.lastname: Giannakikou
authors.forename: Athanasios
authors.initials: A
authors.lastname: Vlachos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Vitoratos
mesh_terms: D000698:Analgesia / Q000009:adverse effects / Q000379:methods*; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D000777:Anesthetics / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D016292:Procedural Sedation / Q000379:methods; D005060:Europe; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D054315:Oocyte Retrieval / Q000379:methods*; D014481:United States
chemical_list: D000777:Anesthetics