Pain Assessment of the IVF Needle

Worldwide, 1.5million artificial reproductive technology cycles are performed
each year.
Since the first description in the early 80s, ultrasound-guided follicular
aspiration is the first choice in the ovum pick-up for artificial reproduction
techniques, like IVF and ICSI. While this procedure is safe and effective, it
is described as one of the most stressful and painful components of the entire
process.
Pain is affected in different ways: use of pain medication, duration of the
intervention, practitioner and thickness of the needle. In many countries, the
IVF procedure is done under the presence of an anaesthesiologist. The
anaesthesiologist will sedate the patient with Propofol during the procedure
and the patient is able to go home at the end of the day. In the Netherlands
the majority of the IVF procedure will take place on an outpatient basis
without the presence of the anaesthesiologist and without the use of Propofol,
after which the patient can go home when she feels ready to go. In the context
of pain-reduction, the various factors mentioned above are explored.

A potential reduction in pain could be obtained by the use of a thinner
aspiration needle, 20 Gauge instead of 14 Gauge used right now. This is the
reason for setting up a study that looks at the effect on pain perception in
women by the use of a thinner needle and to see if there are related adverse
event.

A randomised controlled trial in women who will undergo their first IVF or ICSI
treatment. They will be randomized between a transvaginal ultrasound-guided
puncture with the Sense OD 20/17 Gauge needle and a transvaginal
ultrasound-guided puncture with the Origio 14 Gauge needle. They*re asked to
give a VAS-pain score at four different point during the procedure. In
addition, they receive a questionnaire to take home, in which they have to
report the pain scores, the use of pain medication and the effect of the
puncture on their daily lives during the first 4 days after the procedure.

A transvaginal ultrasound-guided puncture with the Sense OD 20/17 Gauge needle
or a transvaginal ultrasound-guided puncture with the Origio 14 Gauge needle
for ovum pick up.

Nature and extent of the burden and risks for the patients will be the same
with the aspiration needle we use nowadays.