Conscious sedation for oocyte retrieval: Experience at a tertiary health facility in North-Central, Nigeria

Abstract

Background: A variety of anesthetic techniques have been used to make transvaginal oocyte retrieval (TVOR) safe and efficient. The optimal anesthetic technique during TVOR should provide safe, effective analgesia, few side effects, a short recovery time, and be nontoxic to the oocytes that are being retrieved. The concept of conscious sedation is widely accepted for the short-term management of pain. Objective: This study assessed patient's perception of pain using conscious sedation and in-vitro fertilization (IVF) outcomes. Materials and Methods: A cross sectional study of 71 eligible patients that underwent assisted reproduction program in our facility. All clients were treated with antagonist protocol for controlled ovarian hyperstimulation. Self-administered questionnaires were used as the research instrument. Pain was assessed using a 10 cm visual analogue scale (VAS), while client's overall satisfaction was rated using Likert scoring system. Results: Client aged 33.2 ± 4.2 years. Most of them had primary infertility with mean duration of 4.5 ± 2.9 years. Unexplained infertility was the commonest cause of infertility. The pregnancy rate per embryo transfer was 47.9%, miscarriage rate was 5.6%, while the live birth rate was 42.3%. The mean VAS scores at 1 h, 6 h, 24 h and at embryo transfer were 4.9 ± 1.7, 2.5 ± 1.2, 1.3 ± 0.9, and 0.5 ± 0.6, while the Likert score was 3.8 ± 1.1. Conclusion: Conscious sedation with Midazolam and Pethidine is a safe, effective, and acceptable method of analgesia/anesthesia for TVOR. However randomized prospective studies with larger sample sizes are recommended.