Effect of reduced needle versus standard needle on pain experience during oocyte retrieval procedure: a systematic review and meta-analysis of randomized controlled trials

Abstract

Objective

The aim of this study was to compare reduced needle versus standard needle regarding pain experience among women undergoing oocyte retrieval procedures.

Methods

A systematic search was done in Cochrane Library, PubMed, ISI web of science, and Scopus during April 2021. We selected randomized clinical trials (RCTs) compared reduced needle versus standard needle among women undergoing ultrasound-guided oocyte retrieval procedures. Revman software was utilized for performing our meta-analysis. Our primary outcomes were pain scores evaluated by the Visual Analog Scale (VAS) during the procedure, directly post-procedure, and 30 min post-procedure. Our secondary outcomes were the request for more analgesia, clinical pregnancy rate, and rate of vaginal bleeding less than expected.

Results

Six RCTs met our inclusion criteria with a total number of 1063 patients. We found reduced needle was linked to a significant reduction in VAS pain score during and directly after the procedure, respectively (MD= −1.54, 95% CI [–2.38, −0.70], p = .003 and MD= −1.14, 95% CI [–1.38, −0.91], p < .001). After removal of the reported heterogeneity, the reduced needle had significantly reduced the pain score 30 min post-procedure and request for more analgesia in comparison with standard needle (p < .001). No significant difference was found between both groups regarding clinical pregnancy rate (p = .17). More patients in reduced needle group were reported to vaginally bleed less than expected compared to standard needle group (RR = 1.91, 95% CI [1.35, 2.70], p = .003).

Conclusions

Patient perceived pain, analgesic requirement, and vaginal bleeding are decreased with reduced needle administration versus standard needle without affecting the clinical pregnancy rate in oocyte retrieval procedure.

细针与标准针对取卵过程中疼痛体验的影响：一项随机对照试验的系统评价和荟萃分析 摘要

目的：本研究的目的是比较在接受卵母细胞取出术的女性中, 细针与标准针的疼痛体验。

方法：2021年4月间, 在Cochrane图书馆, PubMed, ISI科学网, 和Scopus进行系统检索。我们纳入了随机对照试验（RCT）, 比较了在接受超声引导下卵母细胞取出术的女性中使用缩小内径的细针和标准针的情况。利用RevMan软件进行荟萃分析。主要结果是术中、术后即刻和术后30分钟用视觉模拟量表（VAS）评估疼痛评分。次要结果是更多镇痛需求、临床妊娠率和阴道流血率低于预期。

结果：6项随机对照试验符合我们的纳入标准, 共有1063名患者。研究结果提示细针与术中、术后即刻VAS疼痛评分显著降低有关（MD=–1.54, 95% CI [–2.38, –0.70], p= .003 和 MD=–1.14, 95% CI [–1.38, –0.91], p< .001）。在去除异质性后, 与标准针相比, 细针显著降低了术后30分钟的疼痛评分, 降低了更多镇痛需求（p<0.001）。两组的临床妊娠率无显著差异（p=.17）。与标准针组相比, 更多细针组患者被报道阴道流血少于预期（RR=1.91,95%CI[1.35,2.70], p=0.003）。

结论：与标准针相比, 减少内径的针给药可降低患者的疼痛感、镇痛需求和阴道出血, 且不影响取卵过程中的临床妊娠率。

Keywords:

• Pain
• oocyte retrieval
• needle diameter
• assisted reproduction

Disclosure statement

No potential conflict of interest was reported by the authors.