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Association between differences in body-weight based dose versus actual propofol dosages administered for oocyte retrieval on hemodynamic parameters and reproductive outcomes
Journal article   Open access   Peer reviewed

Association between differences in body-weight based dose versus actual propofol dosages administered for oocyte retrieval on hemodynamic parameters and reproductive outcomes

Madeline Kroeger, Aditi Katwala, Haley Steffen, Karen Summers, Alexis Ireland, Ann Smith, Michael Pomeroy, Rakesh Sondekoppam, Anita Chazhikattu, Amy ET Sparks, …
Proceedings in obstetrics and gynecology, Vol.14(1), 1
05/29/2025
DOI: 10.17077/2154-4751.34426
url
https://doi.org/10.17077/2154-4751.34426View
Published (Version of record) Open Access

Abstract

Objective: To evaluate the dose-dependent effect of propofol in hemodynamic parameters and reproductive outcomes following In-Vitro Fertilization (IVF) oocyte retrieval (OR)Design: Retrospective cohort studySubjects: 1575 women who underwent their first OR under monitored anesthesia care (MAC) and subsequent fresh embryo transfer (ET) between January 2016 through December 2022Exposure: Women in the study were categorized into five cohorts (cohorts A – E) based on increasing dose of total propofol in μg/kg/min.Main Outcome Measures: Primary outcomes were mean differences in ideal dose of propofol based on body weight vs. actual dose administered and the live birth rate (LBR) following a fresh ET. Secondary outcomes included changes in hemodynamic parameters following anesthesia. ANOVA with Tukey post-hoc tests were used to compare means (SD) between the study groups. Paired T-tests assessed the difference between ideal and actual propofol dosing within each groupResults: 1564 women [mean (SD) age (years), 32.77 (4.25) and mean (SD) weight (Kg), 79.49 (20.70)] were included in the final analysis. The live birth rate (LBR) was 815/1564 (52.1%). There was a statistically significant difference in the ideal total dose of propofol and the actual dose administered, mean [(95% CI, P value)] 196.83 [(190.85 – 202.82), <0.001)]. Although not statistically significant, the LBR improved with increasing dose of propofol; 50.2% (cohort A) to 55.4% (cohort E). The adjusted Risk Ratio (aRR), (95% CI) of LBR with an additional mg of propofol/kg/min was 1.25 (0.75 – 2.09). Similar, non-significant improvements were observed in clinical pregnancy rate; 60.1% (cohort A) to 65.7% (cohort E); aRR (95% CI) = 1.25 (0.80 – 1.96). Compared to the start of procedure, there was a statistically significant reduction in mean +/- SD in heart rate (bpm), -8.08 ± 13.01 and mean +/- SD (mm/Hg) systolic BP [-17.44 ± 16.28], diastolic BP [-12.76 ± 13.62] and mean arterial pressure [-14.04 ± 13.16] at the end of the procedure.Conclusion: Despite the statistically significant higher dose of propofol administered during IVF oocyte retrieval and the associated significant changes in hemodynamic parameters; there was a trend of increasing LBR and clinical pregnancy rate with higher doses of propofol.

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