How is anaesthesia used in ovarian puncture for assisted reproduction?

By (gynecologist) and (embryologist).
Last Update: 06/13/2023

Assisted reproduction techniques may require the use of anesthesia in some of their procedures. In particular, the use of anesthesia to perform follicular puncture may cause some concern and worry to the woman.

However, anesthesia makes follicular puncture a more comfortable and painless procedure for the woman, as well as improving her safety.

Generally, the type of anesthesia chosen during follicular puncture is sedation, which allows the patient to leave the fertility clinic a few hours after the procedure.

Use of anesthesia for ovarian puncture

Follicular or ovarian puncture is the procedure by which the eggs inside the follicles in the ovary are aspirated.

In an in vitro fertilization (IVF) process, ovarian puncture is necessary to obtain the oocytes and fertilize them later in the laboratory. However, this procedure is also performed for egg retrieval in donors and in female fertility preservation treatments.

In any case, it is a simple surgical procedure, which is performed after ovarian stimulation with hormonal treatment. In this way, the development of a greater number of follicles is favored, with the objective of obtaining an adequate number of oocytes in the puncture.

Ovarian puncture is performed in the operating room, vaginally and under ultrasound (ultrasound) guidance. Although it is a simple surgery and of short duration, it can cause discomfort and pain to the woman. Therefore, follicular puncture is performed under anesthetic treatment.

However, among the benefits of using anesthesia for follicular puncture, in addition to the woman's comfort, is also its safety. When anesthesia is applied, the patient becomes immobile, which facilitates the work of the gynecologist and avoids possible complications (such as vascular puncture or damage to pelvic organs).

If you want to read more information about follicular puncture, you can do so in this article: What does follicular puncture in an IVF procedure consist of?

Type of anesthesia during follicular puncture

Generally, the type of anesthesia used to avoid discomfort to the woman during follicular puncture is deep sedation, intravenously. The woman remains asleep and is being monitored. The anesthesiologist will be present in the operating room during the entire procedure.

Depending on the degree of anxiety and nerves of the patient, the degree of sedation will be higher or lower, always customizing the levels according to the oocyte load and the physical situation of each patient.

The duration of the anesthesia effect will also be adjusted in each situation, but it is usually about 15-20 minutes (what is necessary to perform the puncture).

After completion of the puncture, the patient returns to the recovery room fully conscious and with adequate analgesia. Subsequently, he will drink water or juice and, if his body tolerates this first intake of food well, he will be discharged.

If after the puncture the woman feels more pain than usual, intravenous analgesics will be administered. However, it is most common for minor discomfort to pass with a conventional analgesic.

Assisted procreation, as any other medical treatment, requires that you rely on the professionalism of the doctors and staff of the clinic you choose. Obviously, each clinic is different. Get now your Fertility Report, which will select several clinics for you out of the pool of clinics that meet our strict quality criteria. Moreover, it will offer you a comparison between the fees and conditions each clinic offers in order for you to make a well informed choice.

Anesthesia recommendations for puncture anesthesia

During the different visits to the fertility center to which the patient or donor attends, she should receive detailed information about sedation. The procedure should be explained, any doubts should be clarified and a questionnaire should be carried out to evaluate the patient's state of health, toxic habits, surgical history and possible pathologies.

It is essential that the woman truthfully report any illness or special situation that may affect or be related to the anesthesia, as well as the use of medications that may interact or affect the dose of anesthesia applied. In this way the anesthesiologists will assess whether or not the patient can receive anesthesia and to what degree.

Therefore, the main recommendation will always be to follow the indications of the team of professionals of the assisted reproduction center chosen. They are the ones who know best the particular situation of women and their needs.

However, general recommendations include:

  • Discuss in detail with the specialist if the woman has any pathology or takes any medication.
  • Fasting for the previous 6-8 hours, without eating or drinking, to avoid possible risks.
  • Go accompanied, since after the puncture there may be some disorientation due to sedation.

After the puncture, the woman will remain approximately 2 hours in the assisted reproduction center. During this period you will be offered water or juice and, after checking that you are well, you can go home. However, it is recommended that you rest and do not exert yourself during that day.

FAQs from users

By Carolina González Arboleya M. D. (gynecologist).

If the patient presents any other symptom that is not directly related to a side effect of the treatment medication itself, such as fever above 37.5ºC, we need to assess the context in depth.
Read more

Can egg retrieval be done without anesthesia?

By Andrea Rodrigo B.Sc., M.Sc. (embryologist).

It is a possibility, but the procedure would be too painful. Besides, if it hurts, the gynecologist cannot proceed with aspiration accurately, so the results would be poorer, the number of complications would increase, and the process would take longer.

What are the side effects of sedation for follicular puncture?

By Silvia Azaña Gutiérrez B.Sc., M.Sc. (embryologist).

Side effects that a woman may experience following sedation administered by the anaesthetist during follicular puncture include:

  • Dizziness or disorientation.
  • Headache.
  • Tiredness.
  • Drowsiness.
  • Discomfort.
  • Nausea.

The risks and more serious complications of sedation are rare, so it is considered a safe procedure.

What is the benefit of sedation during ovarian puncture?

By Silvia Azaña Gutiérrez B.Sc., M.Sc. (embryologist).

Ovarian puncture is a simple surgical procedure performed to obtain oocytes in some assisted reproduction techniques. It is a short procedure, but it can be uncomfortable and painful for the patient. Therefore, anaesthesia will make the procedure more comfortable for the woman.

In addition, sedation and immobility of the patient avoid possible complications, such as puncture of blood vessels or nearby pelvic organs.

Suggested for you

In this article we have mentioned that ovarian stimulation is performed prior to follicular puncture. If you want to learn more about this hormonal treatment, you can visit this link: What is ovarian stimulation - Process, medications and symptoms.

On the other hand, if you are interested in learning more about in vitro fertilization (IVF), we recommend you to read this article: In vitro fertilization (IVF): What is it and how much does it cost?

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Greenberger C, Matot I, Artsi H, Samara N, Azem F. High level of satisfaction among women who underwent oocyte retrieval without anesthesia. Fertil Steril. 2020 Aug;114(2):354-360. (View)

Guasch E, Gómez R, Brogly N, Gilsanz F. Anesthesia and analgesia for transvaginal oocyte retrieval. Should we recommend or avoid any anesthetic drug or technique? Curr Opin Anaesthesiol. 2019 Jun;32(3):285-290. (View)

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FAQs from users: 'Is it recommended to cancel the ovarian puncture if there is fever during the process?', 'Can egg retrieval be done without anesthesia?', 'What are the side effects of sedation for follicular puncture?' and 'What is the benefit of sedation during ovarian puncture?'.

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Authors and contributors

 Carolina González Arboleya
Carolina González Arboleya
M. D.
Dr. Carolina González has a degree in Medicine and Surgery from the University of Santiago de Compostela. Currently, Dr. González is doing a Master in Assisted Reproduction by the Technological University TECH and another one in Aesthetic, regenerative and anti-aging medicine by the Complutense University of Madrid. More information about Carolina González Arboleya
Member number: 282875780
 Silvia Azaña Gutiérrez
Silvia Azaña Gutiérrez
B.Sc., M.Sc.
Graduate in Health Biology from the University of Alcalá and specialized in Clinical Genetics from the same university. Master in Assisted Reproduction by the University of Valencia in collaboration with IVI clinics. More information about Silvia Azaña Gutiérrez
License: 3435-CV

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