Patient comfort in IVF

Oocyte retrieval, a pivotal step in the in vitro fertilization (IVF) process, involves the collection of mature oocytes from the ovaries through ultrasound-directed transvaginal follicle aspiration. Despite its efficacy, this procedure often induces pain and stress, necessitating exploration into various pain relief options.

Conscious sedation, a widely used approach involving a combination of sedatives and local anesthetics, allows patients to remain conscious while minimizing discomfort during the procedure. It has minimal side effects and is low risk, facilitating a swift return to normal activities and early discharge. However, some patients still endure pain and discomfort, leading to the investigation of additional techniques for enhanced comfort and satisfaction. Moreover, it is recognized that a patient’s psychological state has an influence on sedation. Patients experiencing anxiety may require higher sedative doses, posing challenges for clinicians. Recognising the influence of a patient’s mental health, research on non-pharmacological methods to reduce anxiety and improve sedation experience expanding.

Sedation by virtual reality (VR) has been emerging as an innovative method for relieving patients’ pain and anxiety throughout medical procedures. This transformative digital therapy employs three-dimensional multi-sensory immersion, combining clinical hypnotherapy and integrative therapeutics. By stimulating multiple human senses, VR systems create an immersive experience, fostering a feeling of presence in the virtual world. Although the positive psychological impact of VR on sedation outcomes is increasingly being acknowledged, limited research has explored the benefits of VR, specifically hypnosis, in the field of fertility during surgical interventions such as oocyte retrieval.
The preliminary data collected aimed to investigate the anxiety-reducing effects and patient satisfaction associated with VR during oocyte retrieval, focusing on its potential as an alternative to traditional analgesics.

A total of forty patients undergoing oocyte retrieval consented to participate in the VR experience, facilitated through an immersion headset. The VR session commenced, lasting a maximum of 20 minutes. Low doses of fentanyl (75mcg) and midazolam (1mg) were administered as needed, with sedation adjusted to ensure patient comfort. Subsequently, each participant completed a comprehensive questionnaire before discharge, providing insights into pain perception, overall experience, and satisfaction levels.

Results from the questionnaire suggest this non-pharmacological approach is effective and has a positive impact on patient well-being. Notably, 63% of participants reported a high level of immersion during the VR session, while, 95% of patients noted an additional level of comfort during the oocyte retrieval procedure. The most striking statistic was the satisfaction category, with 98% expressing high levels of contentment with the VR session.

A subgroup analysis involved patients with prior oocyte retrieval experience. In this cohort, 93% declared that VR significantly improved their comfort levels during the procedure. Additionally, an equivalent percentage acknowledged an overall enhancement in their experience of the oocyte retrieval process.

In conclusion, the integration of VR in a clinical setting emerges as a promising approach complementing routine sedation, with a notable level of patient adherence. The high satisfaction reported by participants underscores its potential as an easily implementable solution within a clinical setting, offering tangible improvements in patient comfort during oocyte retrieval. These results warrant further investigation through prospective multi-centre studies involving larger cohorts. Such studies are essential to solidify the efficacy of pain management using VR devices in reproductive medicine practice. The future integration of these innovative technologies holds the promise of revolutionizing and elevating the overall patient experience in fertility treatments.

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