Benzodiazepine use during an IVF cycle and its impacts on miscarriage and other pregnancy outcomes.

As infertility becomes more common, the number of women undergoing IVF has increased to achieve pregnancy. An IVF cycle consists of a series of treatments and procedures, including hormone therapy to stimulate ovulation, egg retrieval, fertilization, and embryo transfer. During the process, benzodiazepines can be used to help patients relax before procedures, reduce anxiety, and decrease uterine contractions. However, it remains unclear whether the use of these medications throughout the treatment period has a positive or negative impact on pregnancy outcomes. Therefore, this study investigated the effect of benzodiazepine use during the IVF cycle and found no association with pregnancy outcomes. While a marginal increase in the risk of preterm birth was observed, its magnitude was small. Nevertheless, given the slightly increased risk observed in certain subgroups with specific characteristics, careful consideration of patients’ baseline obstetric and clinical characteristics is warranted when determining whether to use benzodiazepine. Infertility has emerged as a significant global public health concern, with ∼18% of individuals of reproductive age affected as of 2022 (). In parallel with this trend, the use of ART, particularly IVF, has expanded rapidly over the past few decades (). IVF is an ART procedure in which fertilization occurs outside the body, and oocyte retrieval is an essential step in this process. However, oocyte retrieval can induce pain and anxiety; therefore, conscious sedation combined with analgesia is commonly administered in clinical practice (). In this context, benzodiazepines are often used in combination with propofol and/or opioids, contributing to the reduction of peri-procedural psychological stress through their anxiolytic and hypnotic effects (; ; ). In addition, the smooth muscle-relaxant effects of benzodiazepines during embryo transfer (ET) may suppress uterine contractions and thereby facilitate endometrial implantation (; ; ). Beyond their procedural use, benzodiazepines are widely prescribed for the treatment of anxiety disorders, stress-related conditions, and insomnia (), and may therefore be used to manage patients’ psychological status throughout the IVF cycle. In this regard, the pharmacological properties of benzodiazepines may extend to the entire IVF process, thereby potentially contributing to improved reproductive outcomes (; ).