Comparative efficacy of high-flow nasal cannula versus conventional oxygen delivery during procedural sedation for ovum pickup in assisted reproductive technology

Background: Procedural sedation during ovum pickup (OPU) is often associated with transient hypoxemia and airway interventions. High-flow nasal cannula (HFNC) therapy may improve oxygenation during sedated procedures, but evidence in assisted reproductive techniques remains limited. This study compares HFNC with conventional low-flow oxygen (CFO) in maintaining oxygenation during OPU. Materials and Methods: In this randomized controlled trial, 220 women undergoing OPU under propofol sedation were allocated to either CFO (Group C; n = 110) or HFNC (Group H; n = 110). The outcomes assessed included desaturation events, hemodynamic parameters, depth of sedation, airway interventions, and adverse events. Results: Hemodynamic and respiratory parameters remained stable and comparable between groups throughout the procedure and recovery. Desaturation events were more frequent in Group C ( P = 0.161), and the need for rescue escalation of oxygen therapy was significantly higher in this group compared with the group H (13.6% vs. 5.5%; P = 0.03). Total Propofol consumption, procedure duration, recovery time, and adverse events were similar, with high patient and physician satisfaction in both groups. Conclusion: HFNC provides a safe and effective alternative to CFO therapy during procedural sedation for OPU, significantly reducing the need for oxygen escalation without affecting hemodynamic stability, sedation depth, or recovery. Its routine use may enhance respiratory safety in sedated reproductive procedures.