Abstract: P-343

Why Do Women Choose to Undergo Oocyte Aspiration Without Sedation or Analgesia?

Presenter: Daniel Seidman


Abstract


OBJECTIVE: Our aim was to study the reasons that lead women to decide to undergo OPU without sedation and analgesia (SaA).
DESIGN: Oocyte pick-up (OPU) is a painful, but essential, part of in-vitro fertilization (IVF) that is usually performed under SaA. We prospectively studied for the first time why some women choose to undergo OPU without SaA. view more

OBJECTIVE: Our aim was to study the reasons that lead women to decide to undergo OPU without sedation and analgesia (SaA).
DESIGN: Oocyte pick-up (OPU) is a painful, but essential, part of in-vitro fertilization (IVF) that is usually performed under SaA. We prospectively studied for the first time why some women choose to undergo OPU without SaA.
MATERIALS AND METHODS: This was a prospective study using questionnaires to obtain sociodemographic and outcome data. A standardized 7-item Generalized Anxiety Disorder (GAD-7) questionnaire was administered. The patients were asked to assess the pain experienced during OPU using a Visual Analog Scale (VAS). The study sample was a convenience sample of 100 healthy women undergoing OPU at our unit, 50 with and 50 without SaA. All patients were offered SaA free of charge, so economic factors did not play a role in their decision not to use SaA. The study was approved by the institution’s IRB.
RESULTS: Women who chose to undergo OPU without SaA were significantly more likely to express fear of anesthesia, 58% vs. 38% for patients who underwent SaA, p<0.05. The pain score, as expected, was high (VAS 6 or more) significantly more often in patients who underwent OPU without SaA than with SaA, 24% vs. 6%, p<0.05. However, 98% of the patients who underwent OPU without SaA stated that they would still choose in the future to undergo OPU without SaA. The median number of oocytes aspirated was similar among the patient who underwent OPU with or without SaA, 4 (range 1-26) vs. 5 (range 1-41). However, patients who underwent OPU without SaA were significantly more likely to have no more than 2 oocytes aspirated, 46% vs 8%, p<0.05. More patients had high anxiety scores among those who underwent OPU with than without SaA, 12% vs. 6%, respectively, non-significant. Women who did not elect SaA during OPU were less likely to recommend SaA during OPU to a friend, 24% compared to 88% of those undergoing OPU under SaA, p<0.05.
CONCLUSIONS: Women who chose to undergo OPU without SaA reported more often fear of anesthesia and were more likely to have 2 or fewer oocytes aspirated. Although women who underwent OPU without SaA experienced significantly more pain during OPU, almost all of them suggested that they would choose to undergo OPU again without SaA. Increased anxiety, as expressed by higher GAD-7 scores, was not associated with a significant tendency to choose SaA during OPU. The option of OPU without SaA seems to be an acceptable option for selected women.

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