#54 : Patient Tolerability of Local Anesthesia Infiltration of the Vaginal Wall and Parietal Peritoneum During Oocyte Retrieval for Minimal Simulation In-Vitro Fertilization (IVF)

Abstract

Background and Aims: Oocyte retrieval is a brief and minimally invasive procedure occasionally performed under anesthesia due to pain caused by the aspirating needle puncturing the vaginal skin and ovarian capsule during its manipulation within the ovary. Despite different techniques and regimens examined, there is no conclusion on the preferred method for anesthesia and pain relief for these procedures. The purpose of this retrospective cross-sectional study was to assess patient tolerability of local anesthesia for oocyte retrieval. Method: Patients undergoing minimal stimulation IVF were included. The average age of the women was 38.51 ± 4.402 (min. 28, max. 49). 3 ml of 2% lidocaine infiltration was done at the vaginal wall and parietal peritoneum just before oocyte retrieval. Participants rated pain levels at three events: during oocyte aspiration (“intra-op”), right after oocyte retrieval (“post-op”), and 15 minutes post-OPU. The pain scale used ranged from 0 to 10, with 0 being “No pain” and 10 being “Worst pain imaginable”. Results: The average time duration of oocyte retrieval was 7.54 ± 4.57. The average number of follicles aspirated was 4.77 ± 4.04 and the average number of eggs retrieved was 3.62 ± 3.213. Average pain ratings were as follows: Intra-op: 4.152 ± 2.757 S.D. (min. 0, max. 10); 15-min post-OPU: 2.848 ± 2.662 (min. 0, max. 9), and Discharge: 1.711 ± 2.017 (min. 0, max. 8), respectively. There was significant difference in the average pain felt by patients at the three events (p<0.001). According to 55 out of 99 participants who willingly answered the survey, 90.9% were willing to use the same sedation method again. Conclusion: Vaginal wall and parietal peritoneum local anesthesia infiltration helps in making the procedure tolerable for the patient.