Follicular fluid levels of midazolam, alfentanil and fentanyl during ultrasound guided transvaginal oocyte retrieval

Follicular fluid levels of midazolam, alfentanil and fentanyl during ultrasound guided transvaginal oocyte retrieval

Fertil Steril. 1995 Nov;64(5):1003-7; Proceedings of the British Fertility Society, Oxford, UK 1993
International Journal of Obstetrics and Gynaecology, published on the abstract journal
Soussis I, Boyd O, Paraschos T, Duffy S. And Grounds M.

The purpose of this study was to investigate the time course of changes in follicular fluid (FF) concentrations of midazolam (Roche Products Ltd., Welwyn Garden City, United Kingdom), fentanyl (Janssen Pharmaceuticals Ltd., Wantage, United Kingdom), and alfentanil (Janssen Pharmaceuticals Ltd.) during ultrasound-guided transvaginal oocyte collection.

Forty-five patients with tubal infertility were randomized to receive a bolus IV dose of midazolam, fentanyl, or alfentanil for sedation during ultrasound-guided transvaginal oocyte collection. Paracervical block with lignocaine was given for analgesia. Simultaneous blood and FF samples were drawn at 5-minute intervals after the bolus dose for analysis of drug levels.

Data were obtained on 15 women receiving midazolam and fentanyl and on 13 women receiving alfentanil. Plasma levels of all agents rose to a peak and then fell in an exponential fashion as was expected. The FF levels of the agents continued to rise significantly to 25 minutes after the bolus dose, although the absolute level was low when compared with the blood level. There were no significant differences in fertilization or pregnancy rates in the three groups, but patient numbers were small.

We conclude that midazolam, fentanyl, and alfentanil are found in FF after a single IV dose, but further investigation needs to be undertaken to investigate any potential influence on fertilization and implantation rates.

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