AN EVALUATION OF THE EFFECT OF ANESTHETIC TECHNIQUE ON REPRODUCTIVE SUCCESS AFTER LAPAROSCOPIC PRONUCLEAR STAGE TRANSFER - PROPOFOL NITROUS-OXIDE VERSUS ISOFLURANE NITROUS-OXIDE

Background: Laparoscopic pronuclear stage transfer (FROST) is the pref erred method of embryo transfer after in vitro fertilization in many i nfertility programs, There are scant data to recommend the use or avoi dance of any particular anesthetic agent for use in women undergoing t his procedure, The authors hypothesized that propofol would be an idea l anesthetic for laparoscopic FROST because of its characteristic :Fav orable recovery profile that includes minimal sedation and a low incid ence of postoperative nausea and vomiting, The ;purpose of the study w as to compare propofol and isoflurane with respect to postanesthetic r ecovery and pregnancy out comes after laparoscopic FROST. Methods: One hundred twelve women scheduled for laparoscopic FROST were randomized to receive either propofol/ nitrous oxide or isoflurane/nitrous oxide for maintenance of anesthesia. Results: Visual analog scale scores fo r sedation were lower in the propofol group than in the isoflurane gro up at all measurements between 30 min and 3 h after surgery. More wome n experienced emesis and were given an antiemetic during recovery in t he isoflurane group than in the propofol group, However, the percentag e of pregnancies with evidence of fetal cardiac activity was 54% in th e isoflurane group compared with only 30% in the propofol group (P = 0 .023), Also, the ongoing pregnancy rate was greater in the isoflurane group than in the propofol group (54% vs, 29%, P = 0.014). Conclusions : Propofol/nitrous oxide anesthesia was associated with lower clinical and ongoing pregnancy rates compared with isoflurane/nitrous oxide an esthesia,