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

Capsule:
An analysis of ketorolac use after oocyte retrieval over a 5-year period in a population undergoing in vitro fertilization found no differences in pregnancy outcomes.

Authors:
Tolga B. Mesen, M.D., Lamya Kacemi, M.D., Paul B. Marshburn, M.D., Rebecca S. Usadi, M.D., Michelle Matthews, M.D., H. James Norton, Ph.D., Bradley S. Hurst, M.D.

Volume 100, Issue 3, Pages 725-728, September 2013

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.

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