title: Comparison of different anaesthetic methodologies for sedation during in vitro fertilization procedures: effects on patient physiology and oocyte competence.
abstract: The main goal of the present retrospective study is to compare four analgesic methodologies (EMLA cream, propofol, thiopental sodium, sevoflurane) for in vitro fertilization (IVF) oocyte retrieval. We found that most anaesthetic parameters were not significantly different among all treatments. In contrast, significant differences were revealed in all groups for total number of oocytes retrieved per patient, rate of mature oocytes at metaphase II stage (MII) and percentage of fertilization and embryo development. In the EMLA cream and thiopental sodium groups we observed the highest percentage of MII oocytes (P < 0.001). Fertilization rate in the EMLA and sevoflurane groups were similar but significantly higher than the propofol and thiopental sodium groups (P < 0.001). The highest rate of anomalous fertilization was observed in the propofol group. Rate of embryo development was similar in all groups but sevoflurane group had a lower percentage of good embryos. In conclusion, by comparing different anaesthetic techniques with different mechanisms of action and administration, potential negative effects of these drugs on the initial stages of human IVF procedure were revealed. Therefore, a local anaesthetic cream is proposed as an acceptable alternative option for anaesthesia during transvaginal oocyte retrieval.
authors.affiliation: Department of Anaesthesiology, Intensive Care and Pain Medicine, University of L'Aquila, L'Aquila, Italy.
authors.forename: Alba
authors.initials: A
authors.lastname: Piroli
authors.forename: Roberto
authors.initials: R
authors.lastname: Marci
authors.forename: Franco
authors.initials: F
authors.lastname: Marinangeli
authors.forename: Antonella
authors.initials: A
authors.lastname: Paladini
authors.forename: Giovanna
authors.initials: G
authors.lastname: Di Emidio
authors.forename: Paolo
authors.initials: P
authors.lastname: Giovanni Artini
authors.forename: Donatella
authors.initials: D
authors.lastname: Caserta
authors.forename: Carla
authors.initials: C
authors.lastname: Tatone
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000009:adverse effects*; D004477:Ectogenesis / Q000187:drug effects*; D004624:Embryo Transfer / Q000009:adverse effects*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000628:therapy; D008012:Lidocaine / Q000009:adverse effects* / Q000494:pharmacology; D000077442:Lidocaine, Prilocaine Drug Combination; D008499:Medical Records; D008677:Metaphase / Q000187:drug effects; D054315:Oocyte Retrieval / Q000009:adverse effects; D009865:Oocytes / Q000187:drug effects*; D009866:Oogenesis / Q000187:drug effects; D017699:Pelvic Pain / Q000517:prevention & control*; D011247:Pregnancy; D018873:Pregnancy Rate; D011318:Prilocaine / Q000009:adverse effects* / Q000494:pharmacology; D012189:Retrospective Studies; D014622:Vaginal Creams, Foams, and Jellies / Q000009:adverse effects / Q000494:pharmacology
chemical_list: D000077442:Lidocaine, Prilocaine Drug Combination; D014622:Vaginal Creams, Foams, and Jellies; D011318:Prilocaine; D008012:Lidocaine