The effect of ketorolac on pregnancy rates when used immediately after oocyte retrieval

Fertil Steril. 2013 Sep;100(3):725-8. doi: 10.1016/j.fertnstert.2013.04.048. Epub 2013 May 28.

Abstract

Objective: To study the effect of ketorolac, a potent anti-inflammatory medication, on in vitro fertilization (IVF) pregnancy outcomes when used at the time of oocyte retrieval.

Design: Retrospective review of 454 patients from 2003-2009.

Setting: Tertiary hospital-affiliated fertility center.

Patient(s): Consecutive subfertile women undergoing their first IVF cycle.

Intervention(s): Ketorolac administration immediately after oocyte retrieval.

Main outcome measure(s): Pregnancy, implantation, live-birth, and miscarriage rates, and postsurgical visual analog pain score.

Result(s): Of the 454 patients undergoing their first IVF cycle for all indications, 103 received intravenous ketorolac immediately after oocyte retrieval, based on anesthesiologist preference. Patient and procedural characteristics were similar between both groups. The use of ketorolac had no effect on the rates of implantation, miscarriage, pregnancy, live birth, or multiple pregnancy. The patients receiving ketorolac experienced statistically significantly less pain.

Conclusion(s): This study suggests ketorolac has no apparent detrimental effect on IVF pregnancy outcomes when administered immediately after oocyte retrieval. Ketorolac appears to be a safe and effective analgesic to use at the time of oocyte retrieval.

Keywords: Implantation; in vitro fertilization; ketorolac; nonsteroidal anti-inflammatory agents.

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
  • Drug Administration Schedule
  • Embryo Implantation / drug effects
  • Female
  • Fertilization in Vitro / methods
  • Fertilization in Vitro / statistics & numerical data
  • Humans
  • Infertility / epidemiology
  • Infertility / therapy
  • Infusions, Intravenous
  • Ketorolac / administration & dosage*
  • Oocyte Retrieval / adverse effects*
  • Oocyte Retrieval / statistics & numerical data
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / prevention & control*
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Pregnancy Rate*
  • Retrospective Studies
  • Time Factors

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Ketorolac