Sedation for ER - conscious or deep?

[PinkElephants356]

Hello all,

I am very nervous about the egg retrieval and am currently choosing between clinics. It seems some offer nurse led sedation which is light/ conscious sedation with midazolam and alfentanyl and some offer deep sedation with midazolam, alfentanyl and propofol.

I don’t like the thought of being out of control and put under but on the other hand it might be good if I’m very nervous to have more sedation so I’m not awake during the procedure.

Can anyone please give me any insights into which might be better based on their experience please?

I only had full sedation which I loved! The best sleep ever. I think I’d be quite nervous if I was awake as I’d be worried too much about how many eggs are retrieved.

The NHS clinic I went to only did conscious sedation, it was horrendous, felt everything. Definitely go with the deep sedation, you just go to sleep and wake up when it's done!

I had an egg retrieval a few days ago under deep sedation and, based on my experience, I would definitely choose deep sedation again if you have the option.

I personally had no concerns about being – I was much happier with the idea of going to sleep and waking up when it was all over than being conscious during the procedure. Given that they are passing a needle through the vaginal wall and aspirating multiple follicles from your ovaries, being awake for it really wasn’t an experience I felt I needed!

In fact, when I woke up I said to the anaesthetist, “I haven’t been asleep, have I?” and he looked at me and said, “You definitely have.” From my perspective, it felt like virtually no time had passed at all.

Obviously everyone feels differently about sedation, but for me it was absolutely the right choice. Having done it once, I would choose deep sedation again without hesitation, and I’m very glad that my clinic didn’t give me the option of conscious sedation.

Thanks. When you say it was conscious sedation do you know if they still used midazolam so you were kind of out of it or did they not give you anything?

I’ve had deep sedation every time and it’s been great. My friend had conscious sedation a few month ago and she said it was horrific.

Thanks I’m so glad it went well for you.

Im finding the whole thing so overwhelming at the moment.

Can I ask what clinic you used please?

Avenues in London.

Thanks. Yeah I’m really not sure what is best. I don’t like the thought of being ‘put under’ but at the same time I really want to make sure I’m not nervous half way through and they have to stop!

Its all so overwhelming I genuinely don’t know if I can do it!

When you say conscious sedation did they still give her something to make her a bit woozy at least?

If you’re already really nervous about the collection, personally I’d seriously consider the deep sedation if your clinic offers it. It’s not quite the same as a full general anaesthetic – with deep sedation you’re generally asleep but breathing for yourself – and for me it was basically just a short nap. I remember the anaesthetist giving me the medication and then the next thing I knew they were telling me it was finished.

Conscious sedation is absolutely a valid option and plenty of women are happy with it, but if they’re giving you medication to make you relaxed/woozy anyway, I’d ask myself how important it really is to be present for the collection itself. You might not be particularly interested, or capable of watching follicles or keeping track of numbers once you’re sedated.

With deep sedation you can just go to sleep, let them do what they need to do, and when you wake up they’ll tell you exactly how the collection went. If being awake is what’s making you anxious, I personally wouldn’t put myself through that just for the sake of being awake.

Thanks I think that is good advice. Were you able to breath on your own with deep sedation?

I had conscious sedation and really rate it (and I had 31 eggs received) so not a quick process. You're in and out quicker, and lower risk to you. However I don't have anxiety, or struggle a lot with pain, which I imagine would make a big difference.

Yes, I didn’t even realise I’d been asleep when they brought me round.

Yes they used midazolam but it barely had an effect on me, I could still feel everything

Ah this clinic said they use midazolam for sedation and alfentanyl for pain relief, did you have the pain relief part as well?

Thats interesting I hadn’t thought about the recovery time to be honest. Were you aware of what’s going on then in the procedure?

Thanks so much. Thats sound very nice to be honest.

I was in that I was aware of what was happening. Not aware enough to know how many eggs were being retrieved.

The deep sedation for egg retrieval is terrific! When I came around I had a surge of joy and kept telling all the staff “you’re just so nice, so nice”. No grogginess the next day, it’s not like a general anaesthetic or something that took a few days to get over. Honestly it was a tremendous buzz haha

I’ve had midazolam and fentanyl for injections in my back and I was fully conscious (I couldn’t have more as I was having a GA the next day for my endometriosis surgery). I wouldn’t have wanted that experience for the egg retrieval, honestly

The whole thing is just such a stressful process… I would enjoy the jungle juice when they offer it!

I would go for deep sedation. I've had two ECs under deep sedation, the first one I did actually feel the needle go in both ways but was so out of it I didn't really care and it didn't particularly hurt. I did tell the anaesthetist this before the second EC and he increased the dose a bit more, didn't feel a thing that time.

Apparently I was on and off chatting throughout both ECs, telling people about my profession. Probably saying all sorts of rubbish 😂

@PinkElephants356 it was in Denmark and for conscious sedation there they give midazolam and/or fentanyl. She cant remember what she was given but she took whatever she was prescribed so it’ll have been one or a combination of those two. Good luck whatever you choose.

Ok that makes sense thanks. Did you have an anaesthesist there or was it a nurse giving sedation?

Thanks thats very reassuring. Did you just fall asleep? I’m wondering now if it’s best to choose a clinic with an anaesthetist now because then I can have the propofol as well as midazolam and alfentanyl and maybe I would just go to sleep.

So did you go to sleep do you remember?

I like the idea of not knowing what’s going on but I don’t like the idea of them forcing me asleep like I’m guessing a general anaesthetic would be like.

Thanks so much for the information, thats really helpful