BEYOND ANTIEMESIS: EVALUATING INTRAVENOUS DIMENHYDRINATE AS AN ADJUNCT TO CONSCIOUS SEDATION IN IVF OOCYTE RETRIEVALS THROUGH A PROSPECTIVE COHORT STUDY

OBJECTIVE: To evaluate the impact of pre-procedural administration of intravenous dimenhydrinate (IV-DMH) on IVF oocyte retrieval pain scores. DESIGN: Prospective cohort study between Jan 1, 2025-Jan 1, 2026. MATERIALS AND METHODS: Patients (n=318) underwent IVF oocyte retrievals at our university-affiliated clinic: 226 patients consented to IV-DMH while 92 declined and were included as controls. All patients and provider-pairs (nurse providing one-on-one support during procedure) completed VAS questionnaires using a pain scale between 1-10 at its “worst” and on “average”. Patient questionnaires examined how the retrieval compared to their expectations (“better”, “similar”, “worse”) and provider questionnaires additionally assessed post-procedure recovery concerns. Descriptive statistics were reported as mean ± standard deviation. Patient VAS pain scores between IV-DMH vs. Controls were compared using unpaired t-tests. Patient experience and adverse effects associated with IV-DMH were characterized as categorical variables and compared using chi-square tests. RESULTS: IVF oocyte retrievals were a “moderately painful” procedure. No statistically significant differences were noted in patient-reported VAS pain scores on “average”, with mean ± standard deviations as follows (5.12 ± 1.71 IV-DMH vs. 4.94 ±1.67 controls). Similarly, there were no differences in patient-reported VAS pain scores during the “worst” part of the procedure (6.86 ± 1.86 IV-DMH vs. 6.73 ±1.76 controls). Provider-perception of patient pain at its “worst” was significantly different compared to patient report (patient 6.94 vs. provider 6.49; p<0.02). Patients receiving IV-DMH as an adjunct did not have differences in time-to-discharge, ongoing pain, or other side effects compared to controls. Eighty-five percent of patients receiving IV-DMH reported their procedure was “similar” or “better” than expectations, compared to 78% of controls (p<0.05). CONCLUSIONS: IV-DMH prior to oocyte retrieval is a promising adjunct, especially in improving overall patient experience. The observed difference between provider-perceived and patient-reported peak pain poses an opportunity to improve pain assessment and patient-centered analgesic approaches during oocyte retrievals.