Anesthesia for ART procedures have been provided by a variety of anesthetic methods including sedation, regional anesthesia, and general anesthesia. Anesthetic management should be safe, and provide rapid recovery for those women undergoing procedures that are often performed on an ambulatory basis. During ART procedures, anesthetic agents are gradually transferred into follicular fluid. Laboratory studies have suggested that local anesthetic agents, nitrous oxide, volatile halogenated agents, and some intravenous agents, such as propofol, interfere with some aspects of reproductive physiology in vitro. However, there is little clinical data suggesting that brief administration of any of the currently used anesthetic agents for ART procedures adversely affect live birth rates. The concern for antiemetics and NSAIDS use around ART procedures warrants further study. Identification of agents and techniques that provide optimal analgesia or anesthesia with negligible impact on ART success remains an important task for anesthesiologists.