Journal of Human Reproductive Science
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ORIGINAL ARTICLE Table of Contents   
Year : 2013  |  Volume : 6  |  Issue : 4  |  Page : 263-266
Anesthetic management for oocyte retrieval: An exploratory analysis comparing outcome in in vitro fertilization cycles with and without pre-implantation genetic diagnosis


1 Department of Anesthesia, Shaare Zedek Medical Center (affiliated with the Hebrew University-Hadassah Medical School), Jerusalem, Israel
2 IVF Unit, Shaare Zedek Medical Center (affiliated with the Hebrew University-Hadassah Medical School), Jerusalem, Israel
3 IVF Unit; Medical Genetics Institute; ZOHAR PGD Lab, Shaare Zedek Medical Center (affiliated with the Hebrew University-Hadassah Medical School), Jerusalem, Israel
4 Private Statistical Consultant, Toronto, Canada
5 Department of Obstetrics and Gynecology, Shaare Zedek Medical Center (affiliated with the Hebrew University-Hadassah Medical School), Jerusalem, Israel

Correspondence Address:
Deborah Elstein
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, (Affiliated with the Hebrew University-Hadassah Medical School), P.O. Box 3235, Jerusalem
Israel
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-1208.126303

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Purpose: To date, there has been no comparison of outcomes in women undergoing anesthesia for in vitro fertilization (IVF) oocyte retrieval for the purpose of pre-implantation genetic diagnosis (PGD) because of their or their partner's genetic disease relative to the outcome in women requiring IVF because of fertility issues. Materials and Methods: A prospective observational study, wherein all demographic and anesthetic management data were collected from IVF and PGD units' records for a 6-month period. Descriptive analyses and parametric tests were employed. Results: There were 307 cases IVF and 76 cases PGD: most (97.4% and 99.7%, respectively) received general anesthesia with propofol and fentanyl ± dipyrone (90.5% and 93.3%, respectively) with no adverse effects. The only statistically significant difference between IVF and PGD groups that was potentially clinically significant was post-procedure recovery time (23.0 ± 20.4 vs. 29.4 ± 35.8 min, respectively; P < 0.0001), but is explainable as greater caution by Anesthesiologists for higher-risk PGD cases having autosomal dominant diseases that may impact anesthesia management (myotonic dystrophy, neurofibromatosis, Marfan's); two of these cases also recovered in the general post-anesthesia care unit, as a precaution for early diagnosis and treatment of potential post-procedural complication. Conclusions: Results of this first-ever survey of anesthesia for PGD compared with IVF cases imply that propofol-and-fentanyl-based anesthesia is safe and can be recommended, bearing in mind that with patients who have autosomal dominant diseases impacting anesthetic management it is prudent to be more cautious post-recovery.


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