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Not yet recruitingNCT07536425Updated May 4, 2026

Preoperative Indomethacin and Paracetamol for Pain Management During Oocyte Retrieval in IVF Patients

A Phase 4 interventional study of Indomethacin 100Mg Suppository and Paracetamol / Acetaminophen in Pain and Oocyte Retrieval, sponsored by Western Galilee Hospital-Nahariya. Not yet recruiting at 1 site in Israel. Open to female participants aged 18 Years to 45 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-05-04.

Sponsored by Western Galilee Hospital-Nahariya · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
177
Allocation
Randomized
Ages
18 Years to 45 Years
Sex
Female
01

Study summary

This is a randomized controlled trial evaluating the efficacy of preoperative analgesic medications - Indomethacin (100 mg per rectum) and Paracetamol/Acamol (1,000 mg intravenously) - for pain management during oocyte retrieval in women undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

Read the detailed description

Pain during oocyte retrieval is one of the most commonly reported concerns among women undergoing assisted reproductive technology (ART). The procedure involves transvaginal ultrasound-guided aspiration of ovarian follicles, which causes pain through needle puncture of ovarian and surrounding tissues. Adequate analgesia is essential not only for patient comfort but also to minimize procedural stress, reduce the need for deeper sedation, shorten recovery time, and potentially improve treatment outcomes.

Existing analgesic approaches - including paracervical blocks, conscious sedation, and general anesthesia - carry limitations such as hemodynamic risks, prolonged recovery, and increased resource requirements. Randomized controlled trial (RCT) evidence on non-invasive preoperative analgesics for this indication remains limited and methodologically heterogeneous.

This study is a three-arm, randomized, controlled trial comparing two preoperative analgesic regimens against a no-premedication control group in women undergoing oocyte retrieval under standard anesthesia at the IVF Unit, Galilee Medical Centre.

Participants will be randomized to one of three groups:

Group 1: Indomethacin 100 mg per rectum, administered prior to oocyte retrieval Group 2: Paracetamol (Acamol) 1,000 mg intravenously, administered prior to oocyte retrieval Group 3 (Control): No active preoperative analgesic medication

All participants will undergo oocyte retrieval under standard anesthesia protocols. Pain will be assessed using the Numerical Rating Scale (NRS) immediately post-procedure, every 15 minutes for 2 hours, prior to discharge, and again 3 days after the procedure. Patient satisfaction, side effects, need for rescue analgesia, IVF success rates, and cost-effectiveness will also be recorded.

The study adheres to Good Clinical Practice (GCP) guidelines. All participants will provide written informed consent prior to enrollment. The protocol has been reviewed and approved by the relevant institutional ethics committee (Protocol No. 0240-24-NHR)

02

Conditions studied

  • Pain
  • Oocyte Retrieval

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Keywords

  • Oocyte retrieval
  • IVF
  • ICSI
  • Pain management
  • Assisted reproductive technology
  • Numerical Rating Scale
03

Who can participate

Ages eligible
18 Years to 45 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

  • Women undergoing oocyte retrieval for IVF or ICSI
  • Age 18-45 years
  • ASA physical status classification I or II
  • Willing and able to provide written informed consent

Exclusion criteria

Exclusion Criteria:

  • Known allergy or hypersensitivity to Indomethacin, any NSAID, or Paracetamol
  • History of gastrointestinal bleeding or peptic ulceration
  • Renal impairment (GFR \< 30 ml/min/1.73m² or Creatinine > 1.04 mg/dL)
  • Hepatic impairment (ALT > 55 U/L, AST > upper limit of normal, ALP > upper limit of normal, Total Bilirubin > 1.2 mg/dL, or Albumin \< 3.5 g/dL)
  • Participation in another clinical trial that may interfere with the outcomes of this study
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
177 participants (estimated)

Study arms

  • Experimental
    Indomethacin Group

    Participants receive Indomethacin 100 mg per rectum, administered after induction of anesthesia prior to oocyte retrieval.

    Drug: Indomethacin 100Mg Suppository

  • Experimental
    Paracetamol Group

    Participants receive Paracetamol (Acamol) 1,000 mg intravenously, administered after induction of anesthesia prior to oocyte retrieval. Paracetamol Group

    Drug: Paracetamol / Acetaminophen

  • No intervention
    Control Group

    Participants receive no active preoperative analgesic medication. Oocyte retrieval is performed under standard anesthesia protocols only.

Interventions

  • DrugIndomethacin 100Mg Suppository

    Indomethacin 100 mg administered per rectum after induction of anesthesia, prior to oocyte retrieval. Indomethacin Group

  • DrugParacetamol / Acetaminophen

    Paracetamol (Acamol) 1,000 mg administered intravenously after induction of anesthesia, prior to oocyte retrieval.

05

What researchers measure

Primary outcomes

  1. Postoperative Pain Intensity

    Pain intensity assessed using the Numerical Rating Scale (NRS), where 0 = no pain and 10 = worst imaginable pain. Pain is measured immediately after the procedure, every 15 minutes for 2 hours post-retrieval, prior to discharge, and 1-3 days after oocyte retrieval. Scores are compared across the three study arms.

    Time frame: From immediately post-procedure up to 3 days after oocyte retrieval

06

Study locations

1 site
  • Western Galilee Hospital, IVF unit
    Nahariya, Israel
07

References and documents

Publications

  • Buisman ETIA, Grens H, Wang R, Bhattacharya S, Braat DDM, Huppelschoten AG, van der Steeg JW. Trends in research on pain relief during oocyte retrieval for IVF/ICSI: a systematic, methodological review. Hum Reprod Open. 2022 Feb 16;2022(1):hoac006. doi: 10.1093/hropen/hoac006. eCollection 2022. PubMed 35224230 ↗
  • Vlahos NF, Giannakikou I, Vlachos A, Vitoratos N. Analgesia and anesthesia for assisted reproductive technologies. Int J Gynaecol Obstet. 2009 Jun;105(3):201-5. doi: 10.1016/j.ijgo.2009.01.017. Epub 2009 Feb 26. PubMed 19249049 ↗
  • Thanikachalam P, Govindan DK. Pain Management during Ultrasound Guided Transvaginal Oocyte Retrieval - A Narrative Review. J Hum Reprod Sci. 2023 Jan-Mar;16(1):2-15. doi: 10.4103/jhrs.jhrs_141_22. PubMed 37305768 ↗

Individual participant data

Plan to share: Undecided — Individual participant data sharing has not yet been determined. Decisions regarding IPD sharing will be made following study completion, ethical review, and in accordance with the data protection policies of Galilee Medical Centre and applicable Israeli privacy regulations. Requests for data sharing may be considered on a case-by-case basis.

08

Registry details

Key details

Study ID
NCT07536425
Lead sponsor
Western Galilee Hospital-Nahariya
Responsible party
raneen sawaid (Medical Doctor, Fertility Specialist and head of fertility preservation unit, Western Galilee Hospital-Nahariya) — Principal investigator
First posted
Apr 17, 2026
Start date
Apr 13, 2026 (estimated)
Primary completion
Oct 30, 2027 (estimated)
Completion
Dec 31, 2027 (estimated)
Last update
May 4, 2026

Study contacts

Raneen Sawaid Kaiyal, Medical Doctor
Contact
raneen.sawaid@gmail.com
+972502044422
Inbal Paskovetich
Contact
inbalp@gmc.gov.il
9724 9107267

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is not yet recruiting, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.

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