To request conscious sedation for egg retrieval (IVF)

Jesus. I never knew gas and air was even an option.

Get the sedation - you’ll be back round in no time and will be able to leave after about an hour

I had sedation all 3 times, but wasn't given any other choice.

I had my first round with nothing but a paracetamol suppository (standard where it was done). They told me it didn't hurt as there were few nerves where they were working. It took 45 minutes to retrieve 6 eggs and it was incredibly painful. For future rounds I insisted on the twilight sedation.

I had fentanyl and gas and air during my egg retrieval both times. Even with that, it was incredibly painful.
best of luck with your treatment.

I had sedation in Scotland. Don't remember being given the option of gas and air but would have chosen sedation anyway.

Had gas and air during my induction and it did absolutely hee haw except make me feel sick and thirsty.

Wow I would not have wanted gas and air. I had NHS IVF (15 years ago) and was sedated for my egg retrieval, it was absolutely fine and frankly the best sleep of my life!

I have has sedation for both my egg collections. It was standard at our clinic. As a fellow SA survivor and someone who has medical trauma, I would insist on sedation even if you need to pay extra because you may need an anaesthetist present.

With my first round they tried it with me awake (as was standard) and they had to drug me unconscious quite early on. It was agonising and, given the amount of eggs, would have taken ages. Also I found hard to recover from whatever they drugged me with. From then on I insisted on GA, which my body recovers very quickly from.

I had sedation and could still feel it, like a PP I also said ow, they upped something and then I woke up in recovery. Had several
procedures and only felt it once but every time I had no problems with the sedation wearing off. My advice would be kind to yourself OP, this is one thing you can do to make this IVF process less stressful. Good luck with it all

@Oinkypig Egg retrieval has no leeway for time. It has to be done on time, pretty much to the exact hour or else the body releases the eggs. The trigger shot is given at an exact time and then it’s a precise number of hours later that the egg retrieval is done. Are you thinking that the gas and air sedation might be like dental gas sedation? My DD has had that for a filling and she was in a happy la-la land. It definitely took away any anxiety. Pain of course required the usual anaesthetic injections into the gum. She still reacted to pain until the injections gave adequate numbing.

@jacks11 has said it might be because the service doesn’t offer IV sedation. Gas and air is nitrous oxide and can be effective as a mild sedation alongside the analgesia (although to be effective it needs to used alongside what is described a semi hypnotic sedation) If the clinic is offering it only for the analgesic effect you could try practising relaxation techniques you could do by yourself at the time.

IV sedation is usually with midazolam but there are other drugs as well and usually needs an anaesthetist to give or someone trained. I think nurse practitioners can give it. I know it from being an operator/sedationist as a dentist (and we use a lot of gas and air as inhalation sedation) I have no idea how painful or difficult egg harvesting is or if it can be delayed by say 24 hours if you tried gas and air and didn’t mange try a different method the next day?

For either to work it’s all about a good assessment of the patient first and trying to select the patients who it will work for. If you are talking about anaesthetist led sedation they tend to give multiple drugs and unless they have an interest in conscious sedation usually prefer just to give a GA.

Some patients can also have a paradoxical reaction to midazolam where they become really unmanageable and it’s almost like having a few drinks. Patients can become really upset/agitated/cry and don’t have the ability to stop. Gas and air means you retain the reasonable side of the brain and not lose control. You also remember it which can be helpful if you are going to have more procedures because you have the memory of how things went and how well the gas and air worked for you so you become less anxious about the next procedure.

If there is some flexibility trying to manage it with gas and air but with a back up of another sedation/GA in a timely way that could work. Even just the fact you could take the pressure of having to manage because there is another option if you can’t.

It’s not just a case of giving you a different medication there is so much governance around IV sedation that if it’s not part of the current service they can’t give it to you. In my experience it’s almost always anaesthetist led sedation in theatre and if you are doing that you may as well just have a GA.

If you step out of a pathway for any treatment /disease trying to to arrange ad hoc theatre sessions, for example, there will be a delay, you lose any flexibility around appointments (you’ll get the appointment and there won’t be an alternative date or if you were unwell and need to cancel it rearranging will delay things)

If you did try with gas and air and the clinicians can see you can’t manage it they usually end up being a really vocal advocate for alternative help for the patient!

I think this is the longest post I’ve ever written so excuse typos! I hope it makes at least a bit of sense to people.

I hope you manage things with as little stress and pain as possible and everything works out for you soon.

Sedation. Definitely need sedation. I’ve done IVF and had twilight anaesthetic for egg retrieval. From what I can work out that’s the same as conscious sedation. You can breathe for yourself but you have no memory of anything.

I was awake fairly quickly afterwards, ate food, did a wee and was then discharged with a responsible adult (DH). It took me a few days to sleep it off but that’s how I react to general or twilight anaesthetic.

Tell your husband that he can get jabbed through the penis instead if he’s that convinced that gas and air is enough.

oh god, please ask for conscious sedation. I had an egg retrieval last year and definitely needed it. At one point (I was pretty out of it) but I shouted out “it hurts!” And it did! They gave me a bit more and then it was all over. It’s a quick procedure but not pain free at all.

I’ve had IVF 3 times (privately) and was sedated each time for egg retrieval. I only opted for light sedation as I don’t like the feeling of it, but I do think it’s necessary because even with that it was still uncomfortable.

I don’t think I would have been okay with just gas and air.

Gas and air?? Omg no way, I had a sedation with NHS and in Scotland. It is way too painful for just gas and air.

I don’t think you’d be unreasonable to ask for sedation if that is your preference, having had the benefits/risks of the procedure with and without sedation explained to you. My understanding (not my specialty) is that it can be done without sedation, but this approach is generally used when a smaller number of eggs are being retrieved. I think gas & air is safe and I have no doubt used in the correct cases, is absolutely fine. Whether it is suitable for your case, obviously I cannot say. In any case, you aren’t unreasonable to have this preference, regardless of safety/efficacy of the other option.

However, I suppose the issue is whether “do not offer as standard” means they can offer it on request, or whether they do not provide it at all. Or perhaps whether they only offer it when certain clinical are met.

That you feel they should offer sedation doesn’t mean they can. I am a doctor, sometimes we cannot offer something a patient wants because they don’t meet clinical criteria. Our hands can be completely tied by local policy, national guidance, licence restrictions etc. You can appeal if you don’t meet criteria but this will take time so if you are going to do so I’d start that ball rolling now to try to avoid delaying your IVF.

It might be they don’t have the appropriate facilities/clinical staff to offer (heavy) sedation in that clinic. If you are in the UK, heavy sedation (e.g. fentanyl + propofol) requires an anaesthetist. Gas and air would not require this. I am guessing if they do not offer sedation at all, they might not have the staff to do it under any circumstances. They may not have the required equipment either.

Oops, I was citing @GCAcademic

This!!! 1000 x this!

OP, I'm so sorry. Thing is, as you have said, there are two elements to this: your PTSD and then the pain. It sounds incredibly difficult.

FWIW, I've not heard of "most people" experiencing prolonged negative effects from sedation.

Same. I've had different types of sedation, fentanyl which is looovely! I came round fine, just had to have someone with me, and the driving ban.

Then a different type this week on fact which is more like anaesthetic, that made me sick - same re having someone with you and no driving. But they got me up and out pretty quickly. Neither left me groggy after more than an hour or so.

The latter one I woke up in a lot of pain so I'm not convinced it was enough for the procedure and I probably should have had a GA.

Why is it your husband that she's persuading? That would immediately erode my trust in her.

I've had sedation, not for IVF but for a different medical procedure, and this wasn't my experience. I was discharged immediately on coming around, their only stipulation was that I had to have a responsible adult with me and I wasn't allowed to drive. I would have been fine to go back to work the next day, I felt normal, but the no driving was for 24 hours so my insurance wouldn't have been valid if something happened.

It's just a money issue. Nothing about wellbeing at all.
Have you posted on the infertility board about it?

Abso-fucking-lutely not, you need to be sedated. I don't remember any part of either of mine but I had 30+ follicles done each time, no fucking way was I have a needle shot through the wall of my vagina dozens of times without being knocked out for it. I've had gas and air for other procedures and it is great in some ways but it's definitely not enough for egg collection, in my opinion. We used Oxford and they sedated as standard.

Partner (same sex) had this procedure privately and was sedated. Found it fine. Didn’t have to stay in the room for hours and no lasting impact. In fact said it felt really nice going under. Didn’t feel ill afterwards.