Yasser Zaghloul
Anesthesiology Institute – Sheikh Khalifa Medical City, UAE
Title: Does anesthesia have any effect on fertility?
Biography
Biography: Yasser Zaghloul
Abstract
World Health Organization (WHO) estimated that 234·2 million major surgical procedures are undertaken every year worldwide. All were done under general and/or regional anesthesia. About 59% of patients aged >15–59 years. On the other hand, management of pain and anxiety during oocyte retrieval makes anesthesia an important part of the in vitro Fertilization (IVF) procedures. There are many studies investigating the influence of anesthesia on IVF success. Evidence of serious toxicity in humans is not well established. The use of general anesthesia, especially nitrous oxide, for oocyte retrieval has an adverse effect on IVF outcome. This deleterious effect manifests itself only after embryo transfer and leads to lower pregnancy and delivery rates. Some anesthetic agents (propofol, thiopental, midazolam, fentanyl, and alfentanil) can accumulate in the follicular fluid. This can be used only as an indirect index of potential toxicity but cannot prove any real toxic effect on the outcome. Trials regarding different anesthetic techniques ended up without clear conclusions. Studies about General Anesthesia (GA) came up with conflicting results. A few trials relate GA with lower pregnancy rates, although some others failed to prove this conclusion. Furthermore, detectable amounts of some anesthetic agents are measurable in the follicular fluid but these findings are not strongly associated with toxicity. Monitored Anesthesia Care (MAC) and loco-regional anesthesia appears safe alternative choices and there is evidence of improved outcome.