To request conscious sedation for egg retrieval (IVF)

[SquashedSquashess]

I have IVF coming up in the next few months.

Our NHS IVF clinic offers only gas and air as standard for the egg retrieval procedure. Our nurse was emphatic that this is clinically effective, and has persuaded my husband (who won’t be having a needle repeatedly jabbed through his uterus wall into his ovaries) that this is fine.

A friend of mine who has been through IVF recommended sedation, and seemed shocked I’d only be offered gas and air.

I’m concerned that, as with so much in women’s health, this “clinically effective” option is offered to keep costs down without any consideration of whether it’s best for me.

In addition, I previously had PTSD from a rape which I’ve overcome. I’ve been through various intrusive procedures on the IVF journey without incident, but don’t fancy the prospect of being re-triggered if gas and air is going to result in the egg retrieval process being both invasive and painful.

Grateful for any insights from others that have been through this.

YABU: gas and air will be fine
YANBU: request the sedation

I had NHS IVF in the South of England and I was only given an option of sedation for egg retrieval … make this request with the clinic, be firm and refuse the gas and air.

With respect to a number of posters commenting who have not had this procedure, it is not really relevant if you haven't. I would 100% go for sedation. I have had numerous egg collections and all under sedation (which for me meant completely being knocked out- going under in the operating theatre and usually waking up back in my bed or sometimes in the theatre and being helped into a chair but def not fully with it).

I also read some experiences others had with gas and air that scared me and sadly I had a friend going through IVF at a similar time and didn't want to scare her too much about the negative experiences I'd read about as she could only have the gas and air and I think some sort of painkiller maybe but she did have a horrible experience. She said it was painful and she was awake and was saying often it hurt etc (luckily only had 5 follicles to flush) and she doesn't want to do another egg collection. Now I wouldn't be saying this if you had no option...but if you DO then 100% go for the sedation!

I'd recommend watching Making Babies on BBC player if you're interested in seeing what egg collections are like (unless it would scare you) and they did show one same sex couple (saying only so you can find the episode) where the lady couldn't have sedation for medical reasons snd she only had 2 follicles to flush and was shouting out in pain

I had two egg collections and no way would I do them without sedation. I'm a bit shocked that some clinics offer an alternative.

Nitrous oxide and oxygen is Conscious Sedation.

I just had egg retrieval a few weeks ago. Had propofol and fentanyl. Only remember going into the room and them injecting the sedation and then I woke up in recovery. Was the best sleep ever and wouldn’t hesitate to do it again. Highlight of the quite crappy journey 😂 wouldn’t just have gas and air, what if you move?!

Also just to add that there are a few people saying they had GA...i might be wrong but I think they might be mixing up sedation with this as mine was definitely "sedation" but it did feel like a GA and was totally knocked out for the procedure with an oxygen mask etc but I think the difference is you can go home within a couple of hours etc

I have no idea if it was painful because I was off my nut on fentanyl. I would speak to the gynea about your concerns.

I've had egg retrieval twice - first time was with IV fentanyl and oral temazepam. It was agony. Second time was with IV fentanyl and something else IV - can't remember what. Started with half a dose of that and was still finding it painful so they gave me the full dose.

There is not a snowball's chance in hell that I'd just have gas and air for egg retrieval.

For what it's worth, I have a high pain threshold but some painkillers don't have much affect on me.

With the temazepam, I felt fine and went out for lunch afterwards. With the stronger stuff, I had to go home and sleep it off but I didn't have to stay in hospital for long at all really. I wouldn't let the aftermath sway your decision to be honest - it's better to be as comfortable as possible for the procedure.

I have had as several egg retrievals and all under sedation. Not a chance would I use gas and air. Having had to painful labours and the gas and air did nothing. Stand your ground and insist on sedation.

I was sedated for both of my egg retrievals and I can’t imagine it with G&A only. I was in agony when I woke both times- it is a very painful procedure. Please advocate for yourself xx

Just to add, my sedation was through the mask, not IV and I went home after a couple of hours

I’ve had this procedure done with heavy sedation (NHS hospitals) and with conscious sedation (CARE fertility). I strongly recommend you request heavy sedation if available. For me, conscious sedation was feeling the pain but with a foggy head/ difficulty communicating. The private clinics try to avoid heavy sedation so they don’t have to have an anaesthetist, I think, but in the NHS it is standard. What I mean by heavy sedation is apparently they spoke to me throughout but I don’t think I could feel or remember anything. Much, much better. Only an hour or two to recover afterwards and for me, much less traumatic than conscious sedation. Yes, I think there is absolutely a tendency to play down the pain of the procedure.

On no account undergo egg retrieval without being sedated. It’s a needle puncturing your vaginal wall and perforating your ovary - on gas and air you would feel it all and be in agony. Insist on sedation.

I had a egg collection (also in SWE, same clinic???) with g&a it was absolutely fine, quick, and didnt feel much I basically spent the whole time giggling my tits off because of the g&a... they did local anasthetic injections in the vagina for me so maybe that helped me not feel as much... I guess they dont do local anasthetic if your sedated because theres no point since youre asleep anyway... i did ask about sedation but they explained they couldnt give me it because they don't have an anethatist which meant it wasnt safe to give me sedation. Ask the question about if its possible to have sedation but be ready to hear "no" if its the same clinic or the same reason. If they dont have the right staff they cant really change that but if you feel strongly about it ask if maybe you can be put to sleep for it in a proper operating room with an anethatist or ask if you can transfer your NHS care to a different clinic under Right to Choose

I was fully sedated for my retrieval. That’s standard at my clinic in Liverpool

I haven’t had IVF but another person here to say their experiences with sedation were absolutely fine. I had it for a gastroscopy and I was awake and can remember what happened but I don’t have memories of any fear, discomfort etc. It’s as if I heard about or observed the procedure being done to someone else, if that makes sense.

For recovery, I sat for about 10 minutes with an oxygen mask and then the only other waiting was for my husband to collect me. No after effects that I was aware of, we went straight out for dinner and I ate as usual. My husband says I seemed normal. The next day was like it hadn’t happened.

I had my first without any sedation and absolutely would NEVER do it again. For me very traumatic and painful. My second was done with sedation and was fine, though I needed to sleep it off and snugged in bed once home. I was told it was “better” for the eggs to be as drug free as possible. Grim. It wasn’t better for me or for my relationship. Tell your dp “no” and do what’s best for you.

Ask the nurse advising your dh is she has had this procedure and is talking from experience??

And who cares what she has persuaded your dh about, its you getting it done so its up to you.

I didn’t get offered sedation or gas and air. Some pain killers beforehand. Yes it’s a bit sore but I wouldn’t have thought sedation sore! Less sore than childbirth I would say!

Didn’t know gas & air was an option. Had sedation at Guys (NHS & private). Wouldn’t have liked G&A

I also wanted to reassure you OP that while I found that my IVF clinic were pretty terrible when it came to dealing with the fact that I had PTSD (also from a rape) that the same could not be said of anyone I encountered during my pregnancy. From start to finish, my mental wellbeing was a priority and every effort was made to ensure that any potential triggers were removed so I had the best chance of staying mentally well post-birth. It was something on my mind a lot especially during the IVF process which I found very hard to cope with so just in case you had the same worries, I wanted to provide my perspective.

Mine was very unpleasant despite sedation and I would not consent to gas and air if I ever had to do it again.

YANBU - I had a general anaesthetic when I had IVF.
The embryo transfer awake was grim enough.

What do other clinics do these days?

I had IVF recently and had conscious sedation for it - the worst part was having the cannula put in! I don’t remember a thing from
the procedure - I believe it took 20 minutes - and I woke up f the most incredible sleep.
I left probably an hour later after a cup of tea and some biscuits. DH drove us home - felt fine for the rest of the day.
100% insist on sedation - with everything else you’ve been through, they should be bending over backwards to accommodate you!
Ours was a private clinic via NHS referral also in the SW. Put your foot down, gas & air is not good enough.
Good luck OP! And wishing you all the best with the IVF 💜 I’m now 10.5 weeks pregnant after our first round