ABSTRACT
Because of high psychological burden and considerable costs of in-vitro fertilization, it is greatly important to identify all factors that may influence its results. In this study, general anesthesia and spinal analgesia used for oocyte retrieval were compared in terms of success in treating infertility among couples who had undergone in-vitro fertilization at an infertility center in Tehran, Iran. This cohort study that was based on analysis of patient records at Mirza Kochak Khan Hospital, Tehran University of Medical Sciences, in 2008-2009. In this study, the status of chemical pregnancy among those who experienced general anesthesia or spinal anesthesia for in-vitro fertilization for the first time were compared, and the possible effects of clinical and laboratory factors using logistic regression models were considered. Considering the number of transferred embryos, underlying cause of infertility and fetus grade, it was found that practicing spinal anesthesia is significantly related to increased chance of chemical pregnancy [adjusted Odds Ratio=2.07; 95% CI: 1.02,4.20; p=0.043]. According to analysis of recorded data in an infertility treatment center in Iran, it is recommended to use spinal anesthesia instead of general anesthesia for oocyte retrieval to achieve successful in-vitro fertilization outcome. This can be studied and investigated further via a proper multicentric study in the country.
ABSTRACT
Endometrioma of ovary is one of the common diseases during reproductive age and the effect of laparoscopic cystectomy of endometrioma on infertility is still matter of debate. We designed this case control study to evaluate the ovarian response to controlled ovarian hyperstimulation during IVF [In vitro fertilization] cycle following laparoscopic unilateral cystectomy of endometrioma. In a case control study, we enrolled 30 women with history of unilateral laparoscopic cystectomy of ovarian endometrioma in stripping method who underwent IVF cycle in women Hospital, 2009-2012. The numbers of follicles in response to controlled ovarian hyperstimulation during IVF cycle in the ovary with history of unilateral laparoscopic cystectomy of endometrioma were compared with those from the contralateral ovary. The mean age [ +/- SD] of patients was 32.3 [ +/- 3.4]. The mean [ +/- SD] diameter of excised ovarian endometrioma was42.4 [ +/- 10.4] mm. Interval since ovarian surgery to induction ovulation was2.7 [ +/- 2.6] years. Mean number of follicles in the ovary with history of unilateral laparoscopic cystectomy of endometrioma was2.5 [ +/- 1.2] with the range of1 to 5 and in the control ovary 3.9 [ +/- 1.4] with the range of 1 to 6. There was significant difference in the number of follicles in the ovary with laparascopic cystectomy of endometrioma compared with opposite one [P<0.001]. Laparoscopic cystectomy for unilateral endometrioma is associated with a reduced ovarian response to controlled ovarian hyperstimulation during IVF cycle. We did not find any statistically significant difference in reduced ovarian response with regard to patients age, body mass index, size and location of the cyst, and time duration since ovarian cystectomy.