EPIDURAL-ANESTHESIA IN AN IN-VITRO FERTILIZATION AND EMBRYO-TRANSFER PROGRAM

Objectives: To investigate the potential advantages of epidural anesth esia in an in vitro fertilization and embryo transfer program. Study D esign: Between January 1991 and December 1992, 148 infertile patients underwent transvaginal ultrasound guided oocyte retrieval. A total of 44 patients (group A) had 50 retrievals under epidural anesthesia, and 104 patients (group B, control group) 112 retrievals under intravenou s sedation (propofol) with mask-assisted ventilation (nitrous oxide). Results: In group A satisfactory anesthesia was achieved in 49 of the 50 cases (98%); one patient required additional intravenous administra tion of propofol owing to extreme anxiety. No complications were obser ved. Adversely, in group B nausea was observed in 16 cases (14%) and n ausea and vomiting in 7 cases (6%). In group A the fertilization, clea vage and pregnancy rates were 67.2%, 92% and 20% respectively, while i n group B the rates were 69.3%, 93% and 19.6% respectively; the differ ences are not statistically significant. Conclusions: Epidural anesthe sia is an effective method for transvaginal oocyte retrieval but does not improve the treatment outcome as compared to an intravenous sedati on with mask-assisted ventilation using propofol and nitrous oxide.