Abstract: Objective To compare the clinical efficacy and safety of anesthesia with intravenous propofol combined with fentanyl for ultrasound-guided transvaginal oocyte retrieval.Methods Totally 100 unpremedicated infertile women (ASA Ⅰ-Ⅱ) scheduled for oocyte retrieval with ultrasound guidance were randomly divided into two groups to receive anesthesia with either intravenous propofol (group A, n=50) or the combination of propofol and fentanyl (group B, n=50). The time when consciousness loss and recovery occurred, dosage of propofol for anesthesia maintenance, mean arterial blood pressure (MAP), heart rate (HR) and oxygen saturation (SpO₂) were recorded.Results There was no significant difference in the time of consciousness loss between groups A and B (58.8±3.8 s vs 57.7±5.2 s, P=0.283), but consciousness recovery occurred earlier in group B (6.0±0.6 min vs 5.7±0.4 min, P<0.01). The maintenance dosage of propofol in group B (0.20±0.03 mg/kg) was significantly lower than that in group A (0.52±0.05 mg/kg, P<0.01). At 2 min after anesthesia induction, the MAP decreased from 11.1±0.8 kPa to 8.0±0.6 kPa in group A (P<0.05), and from (10.9±0.9) kPa to (8.3±0.7) kPa in group B(P<0.05), and returned to normal within 2-3 min in both groups. The incidence of low SpO₂ (<90%) was lower in group A than in group B ((52% vs 88%, P<0.001).Conclusion Anesthesia with propofol combined with fentanyl may reduce the maintenance dosage of propofol, shorten the time of consciousness recovery during oocyte retrieval with ultrasound guidance, and can be helpful for the patients’ early recovery and discharge from hospital.