title: Anesthesia Related Toxic Effects on In Vitro Fertilization Outcome: Burden of Proof.
abstract: Management of pain and anxiety during oocyte retrieval makes anesthesia an important part of the in vitro fertilization (IVF) procedures. There are many studies investigating the influence of anesthesia on IVF success. This review article provides an overview of published data regarding the potential toxic effects of different anesthetic techniques (Loco-regional, general anesthesia (GA), and monitored anesthesia care (MAC)), different anesthetic agents, and alternative medicine approach (principally acupuncture) on the IVF outcome. From our analysis, evidence of serious toxicity in humans is not well established. Trials regarding different anesthetic techniques ended up without clear conclusions. Studies about GA came up with conflicting results. A few trials relate GA with lower pregnancy rates, although some others failed to prove this conclusion. Furthermore, detectable amounts of some anesthetic agents are measurable in the follicular fluid but these findings are not strongly associated with toxicity. MAC and Loco-regional anesthesia appear as safe alternative choices and there is evidence of improved outcome. Whereas acupuncture may provide assistance increasing IVF success according to some trials, some others could not obtain these effects. Questions about the appropriate time of application and the underlying mechanism of action are not answered yet, so further investigation should be done.
authors.affiliation: 2nd Department of Anesthesiology, School of Medicine, University of Athens, "Attikon" Hospital, Rimini 1 Street, Chaidari, 12462 Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Matsota
authors.affiliation: 2nd Department of Anesthesiology, School of Medicine, University of Athens, "Attikon" Hospital, Rimini 1 Street, Chaidari, 12462 Athens, Greece.
authors.forename: Eva
authors.initials: E
authors.lastname: Kaminioti
authors.affiliation: 2nd Department of Anesthesiology, School of Medicine, University of Athens, "Attikon" Hospital, Rimini 1 Street, Chaidari, 12462 Athens, Greece.
authors.forename: Georgia
authors.initials: G
authors.lastname: Kostopanagiotou
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome