Safety and effectiveness of diclofenac sodium in assisted reproduction treatment: a randomized prospective double-blind study

Insufficient information is available on the safety and efficacy of the potent analgesic diclofenac sodium administered following oocyte retrieval. The present study aims to address this issue. A randomized prospective double-blind study of 381 assisted conception cycles was performed. Patients included were <40 years old with early follicular FSH <10 IU/l and no medical contraindications to receiving non-steroidal anti-inflammatory drugs. Patients were randomized to either receive diclofenac sodium suppository 100 mg (Voltarol®) at the end of oocyte retrieval or nothing. Effect of diclofenac sodium on outcome was assessed. A total of 187 IVF/intracytoplasmic sperm injection cycles were randomized to receive diclofenac sodium at the end of oocyte retrieval and 194 cycles did not receive diclofenac sodium. The number reaching embryo transfer in the two groups was 185 and 190 respectively. The implantation and pregnancy rates per embryo transfer were 25.3 % and 38.9% in the Voltarol group and 21.6% and 32.6% in the group randomized not to receive Voltarol. Use of diclofenac sodium did not significantly compromise the implantation and pregnancy rates. Patients randomized to receive diclofenac sodium had statistically significantly reduced pain scores prior to discharge (P = 0.030). Administration of diclofenac sodium for analgesia following oocyte retrieval did not compromise treatment outcome.