Propofol vs. thiopental NA; pregnancy outcome and postoperative nausea and vomiting [PONV] in art cycle

The aim of this study was to compare the side effects, fertilization rate and pregnancy rate [PR] and duration of recovery between Propofol and Thiopental Na after ICSI-vaginal retrieval of oocyte in ART cycle. This study was a prospective, randomized clinical trial. Ninety eight ASA [American Society of Anesthesiologist] physical status I and II women participating in an intracytoplasmic sperm injection [ICSI] program were assessed. All of the patients underwent general anesthesia induction with Propofol and Thiopental Na. The first group [49 cycles] received 2-2.5mg/kg of Propofol, and the second group [49 cycles] received 5mg/kg Thiopental during transvaginal oocyte retrieval. An informed consent form was obtained for each patient's treatment. Variables under study included: female age, cause and duration of infertility postoperative nausea and vomiting [PONV], heamodynamic changes, mean number of oocyte retrieved, oocyte metaphase II, embryo cleaved, embryo transferred, embryo quality and pregnancy rate [PR] and duration recovery. Statistical analysis was carried out by using SPSS. 10 software and statistical test of T-test and chi-square. The PR in Propofol group was 18 [36.7%] and in Thiopental Na group was 19 [38.8%] with no significant differences the mean duration of infertility and weight weren't statistically significant. The mean number of oocyte retrieved [metaphase II], embryo cleaved, embryo transferred and embryo quality weren't significant between the two groups. The incidence of nausea in Propofol group in comparison with Thiopental Na group was lower with significant differences. The incidence of vomiting between two groups was statistically significant [46.9% vs. 28.6% respectively] [p<0.05] between two groups Duration of recovery in Propofol group was 15 +/- 3 min and in Thiopental Na group was 25 +/- 5 min that was statistically significant [P<0.05]. Propofol offered lowerincidence of post operative nausea and vomiting and a quick recovery from anesthesia without any adverse effect on pregnancy outcome. These findings showed that Propofol was a good alternative for Thiopental Na in short time operation, like ICSI -vaginal retrieval of oocytes

Administration of NTG before embryo transfer does not increase pregnancy rate

Recent studies of uterine contractility in IVF-embryo transfer led us to consider an alternative, and possibly complementary, explanation for the high implantation rates of blastocysts. It has been demonstrated that myometrial contractile activity influences embryo implantation, possibly through mechanical displacement of embryos. The aim of this study was to examine the effect of nitroglycerine [NTG] treatment for priming the uterus on the pregnancy outcome of ICSI-ET programs. This study was a prospective, randomized, double-blinded placebocontrolled clinical trial. One hundred consecutive cycles of ICSI-ET on infertile couples were randomly divided into treatment and control groups. The treatment group [50 cycles] received an oral dose of 0.4 mg of NTG, and the control group [50 cycles] received a placebo, 15 minutes before fresh ET. An informed consent from was obtained from each patients. The main outcomes were implantation rate [IR] and pregnancy rate [PR]. The mean age of females in the control group and in the treatment group were 30.1 +/- 5.1 and 31 +/- 5.5 years respectively. Data showed that the mean duration of infertility was not significantly different between control and treatment groups [6.6 +/- 5.8 versus 7.8 +/- 5.1 years, respectively]. The mean number of oocyte retrieval [metaphase II], 2pn, embryo cleaved, embryo transferred and PR weren't different between two Groups [p>0.05]. Overall PR was 36%, it was 38% in treatment group and 34% in control group but there wasn't statistically significant difference between two groups. [p>0.05] NTG didn't increase PR compared to placebo group. These results suggest that NTG treatment before ET isn't effective in the priming of a uterus