The use of anaesthesia in assisted reproduction is limited to cases where it is absolutely necessary.
The types of anaesthesia used in assisted reproduction: egg retrieval.
When we speak of anaesthesia in treatments of assisted reproduction, we always mean a light sedation, which does not require intubation. A small dose of the anaesthetic Propofol is administered intravenously so that the patient does not have any discomfort during the egg retrieval.
The patient continues to breathe on her own, she is only supported by occasional oxygen supply.
During the egg retrieval, the patient is sedated for about 15 minutes. This is the time needed to fall into a deep sleep and wake up after the procedure.
Although the duration of the operation depends on the number of developed follicles, it is very important that the operation is painless for the patient or donor.
Once the patient is sedated, she begins to relax until she falls asleep deeply. The doctor can then perform the ovarian puncture without the patient moving, which can be very dangerous.
When the patient wakes up, she does not remember absolutely nothing and have no complaints. The recovery time after the procedure could be about 20-30 minutes.
Due to the ease and short duration of the sedation, the patient will not have any unpleasant symptoms.
Anesthesia during embryo transfer
An embryo transfer is a less invasive procedure than ovarian puncture and therefore almost never requires sedation.
The transfer is performed by inserting a speculum into the vagina, using a very thin catheter to transfer the embryos into the uterus. In these cases, the transfer can be complicated: if the uterus is particularly retroverted or if the curve to reach the endometrium is very large. In this case, it will be necessary to use a rigid catheter in which the path can be marked a priori.
If we have a difficult transfer case, we recommend the use of anesthesia or light sedation. In this way the patient does not move and the doctor can reach the endometrium more easily.
During the first visit to ProcreaTec a transfer test is always performed so that the doctor can determine the passage to the endometrium and consider the need for anesthesia during the treatment.
The use of anaesthesia for secondary interventions: TESE and hysteroscopy.
The use of anaesthesia in assisted reproduction is also foreseen for some secondary operations.
- TESE or testicular biopsy is an operation performed when the patient is unable to ejaculate and in cases with a high percentage of DNA fragmentation in semen. In case of testicular biopsy it is necessary to anaesthetize the patient so that he will not have any pain during the operation.
- Hysteroscopy is used to directly examine the inside of the uterus, with the possibility of surgical intervention if necessary: if there are myomas, septa, polyps. Through the hysteroscope, a lens equipped with a camera, the doctor can explore the inside of the uterus and find out that there are no obstacles that could endanger the pregnancy. Hysteroscopy is still an invasive procedure, and without sedation the patient may experience severe pain.
Pre-anaesthetic instructions for assisted reproduction
Although the dosage of the anaesthetic injected during procedures of assisted reproduction is not excessive, it is always advisable to follow some guidelines.
No eating or drinking for at least 8 hours before the procedure and a ban on smoking are the most common indications.
The administration is always carried out by highly specialised anaesthetists.
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