In vitro fertilization is a common treatment for infertility. Ultrasound guided transvaginal follicle aspiration is the standard method for oocyte retrieval and is the most painful part of the IVF process. Adequate anesthesia is needed to reduce pain and ensure patient comfort. Total intravenous anesthesia has been shown to improve quality of recovery after short ambulatory procedures. The ideal anesthetic technique should provide good pain control, quick recovery, minimal side effects, and should not affect oocyte quality. Dexmedetomidine is an alpha 2 receptor agonist that provides sedation, analgesia, and anxiety relief without depressing respiration. It improves patient satisfaction and reduces the need for opioids but may cause bradycardia, hypotension, and limited deep sedation. Ketamine, an NMDA receptor antagonist, produces strong analgesia and preserves airway reflexes and cardiovascular stability. However, its use alone may lead to hallucinations and agitation. Combining dexmedetomidine with ketamine can balance their effects, offering effective sedation and analgesia while minimizing adverse reactions. This study is designed as a prospective randomized controlled trial to compare postoperative recovery time in patients receiving a combination of dexmedetomidine and ketamine using two different techniques during oocyte retrieval. The objective is to identify the safer and more effective method that provides optimal sedation, stable hemodynamics, minimal side effects, and faster postoperative recovery, thereby improving patient comfort and satisfaction in IVF procedures