Liu Xiao-Ming, Zhang Fan, Lu Xiao-Sheng, Xi Hai-Tao, Zhao Jun-Zhao
Reproductive Medicine Centre, Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Front Endocrinol (Lausanne). 2024 Dec 16;15:1497948. doi: 10.3389/fendo.2024.1497948. eCollection 2024.
Propofol, a widely utilized anesthetic, is employed to alleviate pain and anxiety in outpatient oocyte retrieval procedures. However, its potential impact and safety profile in the context of fertilization and embryo transfer (IVF-ET) remain unclear.
This retrospective study enrolled 1187 patients undergoing IVF-ET, and divided into two groups depending on whether they received propofol (propofol group, n=140) or not (control group, n=1047) for anesthesia during oocyte retrieval.
The baseline characteristics were comparable between the groups. Compared with control group, the number of oocytes retrieved in propofol group was more (=0.012), while both the estradiol (E2) level on the trigger day and the pre-ovulatory follicle count were higher in propofol group ((<0.01). Additionally, the rate of preterm delivery was significantly higher in the propofol group (p<0.001). To further analyze the effect of propofol on the oocyte retrieval rate, patients were divided into three subgroups depending on the pre-ovulatory follicle count (≤10, 11-20, and >20) to eliminate the influence of inconsistency in the estimation of the pre-ovulatory follicle count between the two groups. Analysis revealed that the use of propofol during oocyte retrieval was particularly advantageous in the subgroup with a pre-ovulatory follicle count of 11-20, yielding a higher oocyte retrieval rate (p<0.001).
The use of propofol in oocyte retrieval did not adversely affect fertilization, embryo quality, or clinical outcomes. Moreover, it was found to increase the oocyte retrieval rate among patients with an estimated pre-ovulatory follicle count of 11-20. These findings offer valuable evidence supporting the clinical application of propofol in oocyte retrieval procedures.
丙泊酚是一种广泛应用的麻醉剂，用于减轻门诊取卵手术中的疼痛和焦虑。然而，其在受精和胚胎移植（IVF-ET）背景下的潜在影响和安全性仍不明确。
这项回顾性研究纳入了1187例行IVF-ET的患者，根据她们在取卵时是否接受丙泊酚麻醉（丙泊酚组，n=140）或未接受丙泊酚麻醉（对照组，n=1047）分为两组。
两组的基线特征具有可比性。与对照组相比，丙泊酚组取出的卵母细胞数量更多（=0.012），而丙泊酚组触发日的雌二醇（E2）水平和排卵前卵泡计数均更高（<0.01）。此外，丙泊酚组的早产率显著更高（p<0.001）。为进一步分析丙泊酚对取卵率的影响，根据排卵前卵泡计数（≤10、11-20和>20）将患者分为三个亚组，以消除两组间排卵前卵泡计数估计不一致的影响。分析显示，在取卵时使用丙泊酚在排卵前卵泡计数为11-20的亚组中特别有利，产生更高的取卵率（p<0.001）。
在取卵中使用丙泊酚对受精、胚胎质量或临床结局没有不利影响。此外, 发现它能提高估计排卵前卵泡计数为11-20的患者的取卵率。这些发现为丙泊酚在取卵手术中的临床应用提供了有价值的证据。
