Assisted reproductive technologies (ART) refers to a set of techniques utilizing reproductive cells and/or embryos outside of the body to help patients conceive. These technologies have been made possible by advances in endocrine assays, controlled ovarian stimulation, cryopreservation, ultrasonography, and a range of procedures on oocytes, sperm, and embryos. An ART physician is a gynecologist specially trained in reproductive endocrinology. In vitro fertilization (IVF) is a term used to describe the process of obtaining an oocyte and uniting it with sperm outside of the body, and later transferring the developing embryo into the uterus. The most common method for obtaining oocytes is the transvaginal ultrasound-guided oocyte retrieval. This procedure is also the most painful part of an IVF cycle and therefore requires sedation and analgesia. This chapter focuses on sedation for oocyte retrieval and related ART procedures.

Genetic disorders commonly present or show severe manifestations early in life and in reproductive-age women. The impacts of such disorders in pregnancy are complex, often involving both mother and fetus. This chapter provides an overview of key concepts in genetics, focusing on the patterns of inheritance of monogenic disorders. The features and management of several common disorders are discussed, including alpha-1 antitrypsin deficiency, autosomal dominant polycystic kidney disease, Charcot Marie Tooth disease, Ehlers Danlos syndrome, Loeys-Dietz syndrome, glucose-6-phosphate dehydrogenase deficiency, Down syndrome, Turner syndrome, and mitochondrial disorders with a focus on management considerations, relevant for the practice of the obstetric anesthesiologist.