Why do I need an anesthetic and what will it be?
Egg retrievals would be quite uncomfortable without an anesthetic of some kind. For
several years, the Shady Grove Fertility Reproductive Science Center has been using
what can be called light general anesthesia, “unconscious” sedation, heavy
sedation or total intravenous anesthesia (TIVA) – all the same thing. It is a
quick sleep and a rapid wake up with little “hangover” or groggy feeling.
We use this as our primary anesthetic because it is very well tolerated and the one
our patients prefer. Also, because our pregnancy rate is so exceptional we have chosen
to stay with a technique that works. We also use this same anesthetic for cyst and
fluid aspirations, hysteroscopies and D&Cs. All of the drugs we use go through
an intravenous line, which we routinely start with a local anesthetic. You’ll
also be breathing oxygen through a nasal cannula.
Male procedures are done with this same anesthetic technique. In addition, the physician
uses local anesthetic injections prior to starting the procedure. If the procedure is certain
to only be a percutaneous epididymal sperm aspiration (PESA), it can be done with local
anesthesia only without any sedation. Check with your physician about your choice of anesthesia.
If a PESA is not a certainty it is best to be sedated/anesthetized for the procedure so as not
to be uncomfortable and create a delay in going to the next more invasive step, which is usually
a testicular sperm aspiration, or occasionally a testicular biopsy. back to top
Who will be administering my anesthetic?
Certified Registered Nurse Anesthetists provide anesthesia.
Our team has performed over 8,000 IVF retrievals. As anesthesia professionals, we stay with you throughout the procedure,
always monitoring you closely. Our entire role is to ensure that you are safe and comfortable
during the procedure. back to top
What about eating and drinking before this anesthetic?
You must not eat any solid food or drink any opaque liquids for seven hours before your procedure.
If you can see through the liquid, such as water, broth, bullion, apple juice, or kool-aid, you
may drink it in moderation up to four hours before your procedure. You may also drink tea or
coffee without cream or milk. Please do not drink carbonated liquids. If your procedure is
scheduled after noon we want you to get up early for a light breakfast and we want you to drink
up to four hours before your procedure. We have found that people who have procedures after 1PM
who have been fasting for a long time have poor venous access to start an IV and are more prone
to post-procedure nausea and vomiting. So, please make the effort to get up early and follow
these intake guidelines. back to top
What about non fertility medicines and herbs I take regularly?
We WANT you to take your prescription drugs, with a few sips of water, before leaving
home. Please also bring the bottle with you. It is very important that you take drugs such as
blood pressure medicine, stomach acid medicine, and asthma medication the morning of your
procedure. If you have asthma, bring your inhaler with you. We may have you take a puff or two
before we start the anesthetic. If you do not know exactly what medicines you take, bring the
bottle with you. If you take herbs we suggest that you stop immediately. Some of them cause
blood clotting problems and others interact with anesthesia drugs and can create a high blood
pressure crisis. If you have insulin dependent diabetes be sure your primary nurse is aware so
you can be given specific instructions for that day. Please bring your insulin with you and
your blood sugar test equipment. back to top
Who will care for me in the recovery room when I’m waking up?
You will actually wake up in the operating room at the end of the procedure and move yourself
onto the recovery room bed. So you will be quite awake even before you get to the recovery room.
You may not remember that however, because the drugs we use do create a considerable amount of
amnesia. The Shady Grove Fertility Reproductive Science Center has full time registered nurses
that staff the recovery room seven days a week. All of these nurses are well qualified to care
for you.
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Will I have pain after the procedure?
Women may experience varying degrees of cramping sensations after a retrieval. We’ll give
you analgesic medication, as you need it. Most people need nothing or only two acetamenophen
(Tylenol). Men usually have no pain after their procedures because the local anesthetic is still
working. Women and men who need a prescription for a stronger analgesic (pain killer) will be
given one. back to top
Will I have a tube down my throat?
Very rarely. The tube you are referring to is called an endotracheal tube. We usually do not need
to intubate our patients. The procedures are very brief and our patients usually have good airways
that do not require artificial devices to keep them open. If medically required, we can use
intubation. back to top
What are the risks of the anesthetic?
The chance of a life threatening complication in healthy patients is about one in a quarter of a
million. We keep you lightly anesthetized because that is the perfect level for these procedures.
If a problem occurs we can quickly wake you up. If we have to use emergency life support equipment
we are well trained and experienced in their use. back to top
