Effects of general anesthesia with propofol during oocyte retrieval on embryo morphokinetics and clinical outcomes: a retrospective cohort study

Propofol is widely used for general anesthesia during oocyte retrieval; however, its potential impact on early embryonic development remains debated. This study aimed to investigate whether propofol-based general anesthesia affects embryo morphokinetics, assessed by time-lapse imaging (TLI), and subsequent clinical outcomes. In this single-center retrospective cohort study, 210 infertile women undergoing IVF/ICSI between April and July 2023 were included. Patients were divided into a general anesthesia (GA) group ( n = 101) receiving propofol and a control group ( n = 109) without GA. All embryos were cultured in a TLI system for continuous monitoring. Primary outcomes were embryo morphokinetic parameters. Secondary outcomes included laboratory parameters (fertilization, cleavage, blastulation rates) and clinical outcomes (clinical pregnancy, miscarriage, and live birth rates) after fresh embryo transfer. Baseline characteristics and ovarian stimulation outcomes were comparable between groups. The number of oocytes retrieved and key laboratory parameters (2PN fertilization rate, cleavage rate, day 3 good-quality embryo rate, blastocyst formation rate) did not differ significantly. Most importantly, TLI analysis revealed no significant differences in any measured morphokinetic parameters, including timings of pronuclear appearance (tPNa), cleavage to 2–8 cells (t2-t8), and blastocyst formation (tB) and expansion (tEB). Clinical pregnancy rates, miscarriage rates, and live birth rates were also similar between the two groups. Propofol-based general anesthesia during oocyte retrieval does not adversely affect early embryo morphokinetic patterns or developmental competence, as meticulously documented by time-lapse technology. Furthermore, it does not compromise standard laboratory efficiency or key clinical pregnancy outcomes. These findings provide reassuring data supporting the safety of propofol in this setting, allowing its use to optimize patient comfort without compromising treatment success.