Pain experience during transvaginal aspiration of immature oocytes

Abstract

We wanted to determine the pain conception prior to, during, and after transvaginal recovery of immature oocytes for in vitro maturation (IVM). Fifty women received 1 g Paracetamol and 0.125 mg Halcion as preanalgesics. During the oocyte pick-up para-cervical blockage (PCB) with 5 ml Citanest x2 was given, in addition to 1.5-2 ml Raphiphene intravenously. The pain was measured by using a visual analog scale (VAS). The expected pain was recorded just before the oocyte pick-up. Right after the oocyte pick-up the actual pain was measured and again 1/2 hour, and 1-11/2 hour later. Furthermore, the pain was recorded every second hour after discharge and every third hour the next day. Forty-three women experienced less pain than expected (p=0.003). The pain conception was correlated to the number of punctures through the vagina (p=0.012). Fifteen patients received analgesics postoperatively, and all patients were discharged less than 2 hours after the procedure without complaints. None noted any discomfort or pain after 30 hours following the oocyte pick-up. Although the IVM oocyte pick-up procedure involved puncture of very small follicles that required numerous punctures through the vagina, the experienced pain was significantly less than the expected pain, and the procedure was well accepted.