Abstract
(1) Background: There has been various reports on the potential impact of anesthetic agents used during oocyte retrieval (OR) on the impairment of the capacity of the oocyte for fertilization and subsequent embryo quality; results have been conflicting; (2) Methods: The effects of two different sedation protocols during OR in two groups of patients undergoing In Vitro Fertilization/Intra-Cytoplasmic Sperm Injection IVF/ICSI, were compared on propofol consumption and on in vitro fertilization (IVF)/ICSI success. The study group received dexmedetomidine and fentanyl, while the control remifentanil and midazolam. In a prospective cohort study, we encompassed 72 cycles/patients. The administered dose of propofol per patient and fertilization rates were the primary outcomes, while anesthesiological parameters and IVF/ICSI outcomes were the secondary endpoints; (3) Results: We found a significant increase in propofol consumption in the study compared to the control group (77.0 ± 10.6 mg vs. 12.1 ± 6.1; p < 0.001), but fertilization rates were similar (p = 0.469). From the secondary anesthesiological outcomes, the post anesthesia discharge scores were better in the control group (15.0 (13.5 min) vs. 5.0 (10.0 min), p = 0.028). From the IVF/ICSI secondary outcome parameters, we found a higher quality of embryos on day three in the study compared to the control group (p = 0.040). The comparison of the other secondary outcomes yielded non-significant differences; (4) Conclusions: The use of dexmedetomidine, as an alternative agent during OR, was associated with higher propofol consumption as a rescue dose compared to remifentanil but was linked with similar fertilization rates and higher quality of embryos produced.
Highlights
There is data that shows that conscious sedation (CS)—when used in oocyte retrieval (OR)—compared to general anesthesia is associated with higher in vitro fertilization (IVF) success rates, in terms of higher pregnancy and live birth rates [2]; the optimal/effective analgesic-sedative regimen has not been determined yet [3]
The aim of this study was to compare the effect of two different regimens for conscious sedation during OR, namely Monitored Anesthesia Care (MAC) with dexmedetomidine and fentanyl versus MAC with midazolam and remifentanil, on total propofol administration
There was a significant increase in propofol consumption in group DEX compared to group REMI (77.0 ± 10.6 mg vs. 12.1 ± 6.1; p < 0.001; Table 3a), but fertilization rates were similar (p = 0.469; Table 3b)
Summary
There is data that shows that conscious sedation (CS)—when used in OR—compared to general anesthesia is associated with higher in vitro fertilization (IVF) success rates, in terms of higher pregnancy and live birth rates [2]; the optimal/effective analgesic-sedative regimen has not been determined yet [3]. In this context, a fast-track anesthetic regimen, consisting of a combination of anesthetic, 4.0/). It has been linked with positive effects at the level of receptors, of both neurons and endothelium [11,12]
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