Introduction:
Ultrasound guided transvaginal oocyte retrieval for in vitro fertilization (IVF) is a very common procedure [1]. Although some patients prefer the procedure to be performed without anesthesia, it is recommended to be performed under anesthesia as it is a short but painful procedure [2, 3]. Performing the procedure with anesthesia not only increases the comfort of the patient, but also facilitates the procedure, and prevents the patient from being damaged due to trauma during the procedure [3]. For this purpose, different anesthetic techniques such as monitored anesthesia care, sedation, local anesthesia, regional anesthesia, and general anesthesia can be used during the oocyte retrieval procedure [3, 4, 5]. The combination of sedative and analgesic drugs with a rapid onset and a short duration of action is ideal in this day-case procedures.
Propofol (2,6-diisopropylphenol) and fentanyl are commonly used agents in oocyte retrieval procedures. Propofol is used as continuous intravenous infusion or intermittent bolus injections [6].
Although propofol is widely used during oocyte retrieval, studies on its effects on fertilization are controversial. In vitro studies on mouse oocytes [6] and some human studies have shown that propofol may be dose- and time-dependent detrimental to fertilization [7]. Propofol is detected in significant concentrations in the follicular fluid, depending on the dose and the duration of propofol administration [8]. Due to its potential adverse effects on fertilization, there are studies suggesting that propofol should be used with caution during oocyte retrieval [6] the total dose should be strictly limited [8]. Therefore, our aim is to use as low amount of propofol as possible during oocyte retrieval.
BIS monitoring systems provide an objective measure of a patient’s depth of consciousness [9]. A BIS value between 40 and 60 indicates the appropriate level of general anesthesia recommended by the manufacturer and in previous studies [10, 11]. It has been demonstrated that titration of propofol with BIS monitoring during anesthesia reduces propofol use [9, 12].
Our hypothesis was that during the transvaginal oocyte retrieval procedure, the amount of propofol given as an infusion with BIS monitoring would be less compared to the amount used when bolus doses are given according to the clinical evaluation.