Assisted reproduction technology: Comparison of anesthetic techniques for oocyte retrieval in a tertiary health facility in Ilorin, Nigeria

Abstract

Background: Transvaginal ultrasound-guided oocyte retrieval (TUGOR) technique is minimally invasive and requires shorter time compared to previous techniques. Yet, it is a potentially stressful and painful procedure and thus requires some form of analgesia with or without sedation. The effects of various anesthetic techniques used for TUGOR on reproductive outcomes remain controversial. Aims and Objectives: This study aimed at comparing the efficacy of paracervical block (PCB) and conscious sedation for pain relief and pregnancy outcomes during TUGOR. Materials and Methods: This is a cross-sectional comparative study of 137 eligible clients that underwent assisted reproduction program in our facility. All clients were treated with antagonist protocol for controlled ovarian hyperstimulation. The choice of analgesia for TUGOR was influenced by clients' and/or clinicians' preference. PCB and conscious sedation were administered for TUGOR in 66 and 71 clients, respectively. Pain was assessed using a 10-cm Visual Analog Scale (VAS), while clients' overall satisfaction was rated using Likert scoring system. Results: There was no statistically significant difference in the clinical pregnancy, miscarriage, and live birth rates between the two groups. The mean VAS 10-point scores at 1, 6, and 24 h postretrieval and on the day of embryo transfer were significantly higher for paracervical group. The mean Likert score for conscious sedation group was significantly higher than that of paracervical group. Conclusion: Conscious sedation is superior to PCB as anesthetic/analgesic agent for pain relief and clients' satisfaction for TUGOR. However, a multimodal approach to anesthesia/analgesia for TUGOR is suggested to further improve overall clients' satisfaction.