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Background <p>The optimal anaesthetic regimen for transvaginal oocyte retrieval remains a subject of ongoing discussion, with some studies suggesting possible effects on oocyte quality and subsequent embryological outcomes. This study aimed to evaluate the efficacy, safety, and embryological outcomes associated with three anaesthesia protocols for in vitro fertilisation (IVF) in a Ghanaian clinical setting.</p> Methods <p>A prospective comparative cohort study was conducted at Oak Specialist Hospital in Kumasi, Ghana, involving 155 women with ASA Physical Status I and II who underwent IVF. Participants were divided into three groups based on the anaesthetic protocol used: Group A (propofol/fentanyl TIVA via nasal prongs), Group B (propofol/fentanyl induction with sevoflurane maintenance via LMA), and Group C (propofol/fentanyl induction with isoflurane maintenance via LMA). Intraoperative haemodynamics, post-operative recovery times, side effects, oocyte yield, and fertilisation rates were compared.</p> Results <p>The mean age of the participants was 29.16 ± 6.84 years. Intraoperative haemodynamics and postoperative recovery times did not differ significantly among the groups (<i>p</i> &gt; 0.05). Postoperative vomiting was significantly lower in Group B (0%) than in the other groups (<i>p</i> = 0.031). While oocyte yield was highest in Group C (<i>p</i> = 0.001), the normal fertilisation rate (2PN/MII) was significantly higher in the sevoflurane group (Group B: 47.85%) compared with the isoflurane group (Group C: 30.06%) and the TIVA group (Group A: 43.47%) (<i>p</i> = 0.009).</p> Conclusion <p>Sevoflurane-based balanced anaesthesia was associated with a higher normal fertilisation rate and a lower incidence of post-operative vomiting compared with propofol-based TIVA and isoflurane-based regimens, without compromising haemodynamic stability or recovery speed. These findings support the use of sevoflurane as a preferred option when embryological outcomes are prioritised, though live-birth data are needed to confirm clinical superiority.</p>

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Volatile Anaesthesia Versus Total Intravenous Anaesthesia for Transvaginal Oocyte Retrieval in IVF: A Prospective Comparative Cohort Study from Ghana

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  • 发表日期：

    2026年7月14日

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  • Rex Mawuli Kwadjo Djokoto,
  • Wilfred Kwamina Jnr Sam-Awortwi,
  • Nana Addo Boateng,
  • Irene Bandoh,
  • Augustine Tawiah,
  • Edward Anabila Agana,
  • Kingsley Afreh Nduroh,
  • Johnny Arthur-Komeh,
  • Opei Adarkwa,
  • Andrew Panyin Vormawor,
  • Amponsah Peprah,
  • Anthony Amanfo Ofori,
  • Victor Boachie Owusu,
  • Isaac Kofi Adu

摘要

Background

The optimal anaesthetic regimen for transvaginal oocyte retrieval remains a subject of ongoing discussion, with some studies suggesting possible effects on oocyte quality and subsequent embryological outcomes. This study aimed to evaluate the efficacy, safety, and embryological outcomes associated with three anaesthesia protocols for in vitro fertilisation (IVF) in a Ghanaian clinical setting.

Methods

A prospective comparative cohort study was conducted at Oak Specialist Hospital in Kumasi, Ghana, involving 155 women with ASA Physical Status I and II who underwent IVF. Participants were divided into three groups based on the anaesthetic protocol used: Group A (propofol/fentanyl TIVA via nasal prongs), Group B (propofol/fentanyl induction with sevoflurane maintenance via LMA), and Group C (propofol/fentanyl induction with isoflurane maintenance via LMA). Intraoperative haemodynamics, post-operative recovery times, side effects, oocyte yield, and fertilisation rates were compared.

Results

The mean age of the participants was 29.16 ± 6.84 years. Intraoperative haemodynamics and postoperative recovery times did not differ significantly among the groups (p > 0.05). Postoperative vomiting was significantly lower in Group B (0%) than in the other groups (p = 0.031). While oocyte yield was highest in Group C (p = 0.001), the normal fertilisation rate (2PN/MII) was significantly higher in the sevoflurane group (Group B: 47.85%) compared with the isoflurane group (Group C: 30.06%) and the TIVA group (Group A: 43.47%) (p = 0.009).

Conclusion

Sevoflurane-based balanced anaesthesia was associated with a higher normal fertilisation rate and a lower incidence of post-operative vomiting compared with propofol-based TIVA and isoflurane-based regimens, without compromising haemodynamic stability or recovery speed. These findings support the use of sevoflurane as a preferred option when embryological outcomes are prioritised, though live-birth data are needed to confirm clinical superiority.