Article

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

Authors

• • Madeline Kroeger
  • Dept. of Obstetrics and Gynecology, Carle Foundation Hospital, Urbana, Illinois, USA.
  • United States
• • Aditi Katwala
  • Carver College of Medicine, University of Iowa, Iowa City, Iowa. USA
  • United States
• • Haley Steffen
  • Dept. of Obstetrics and Gynecology, University of Iowa Health Care, Iowa City. Iowa. USA
  • United States
• • Karen Summers
  • Dept. of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Iowa Health Care, Iowa City. Iowa. USA.
  • United States
• • Alexis Ireland
  • Dept. of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Iowa Health Care, Iowa City. Iowa. USA
  • United States
• • Ann Smith
  • Dept. of Anesthesia, University of Iowa Health Care, Iowa City. Iowa. USA
  • United States
• • Michael Pomeroy
  • Dept. of Anesthesia, University of Iowa Health Care, Iowa City. Iowa. USA
  • United States
• • Rakesh Sondekoppam
  • Dept. of Anesthesia, Perioperative and Pain Medicine, Stanford University, Palo Alto, California. USA
  • United States
• • Anita Chazhikattu
  • Dept. of Anesthesia, Division of Critical Care, University of Iowa Health Care, Iowa City. Iowa. USA
  • United States
• • Amy ET Sparks
  • Dept. of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Iowa Health Care, Iowa City. Iowa. USA
  • United States
• • Jessica Kresowik
  • Dept. of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Iowa Health Care, Iowa City. Iowa. USA
  • United States
• • Abey Eapen abey-eapen@uiowa.edu Email Abey Eapen. (compose email, opens in email app.) Abey Eapen ORCID profile. (opens in new tab)
  • Dept. of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Iowa Health Care, Iowa City. Iowa. USA
  • United States

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 study

Subjects: 1575 women who underwent their first OR under monitored anesthesia care (MAC) and subsequent fresh embryo transfer (ET) between January 2016 through December 2022

Exposure: 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 group

Results: 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.

Keywords: Ideal dose, actual dose, propofol, monitored anesthesia care, pregnancy outcomes

How to Cite: Kroeger, M. , Katwala, A. , Steffen, H. , Summers, K. , Ireland, A. , Smith, A. , Pomeroy, M. , Sondekoppam, R. , Chazhikattu, A. , Sparks, A. E. , Kresowik, J. & Eapen, A. (2025) “Association between differences in body-weight based dose versus actual propofol dosages administered for oocyte retrieval on hemodynamic parameters and reproductive outcomes”, Proceedings in Obstetrics and Gynecology. 14(1). doi: https://doi.org/10.17077/2154-4751.34426