Background: Numerous human and experimental investigations have shown that anesthetic substances exist in follicular fluid, potentially having effects on hormone concentration, embryo quality, and the success of following fertilization and implantation rates. Objective: Aim to evaluate the impact of medications used for general anesthesia (remifentanil vs. fentanyl) on the results of ICSI, the concentration of hormones in follicular fluid, and oocyte retrieval. Patients and methods: The current prospective comparative study was approved by the ethics committee of the Faculty of Science at Mansoura University in Egypt. It was carried out at the infertility center of the "High Institute of Infertility Diagnosis and Assisted Reproductive Technologies/Reproductive Physiology/Al-Nahrain University/Baghdad/Iraq." Sixty infertile women who were undergoing intracytoplasmic sperm injections (ICSI) for various infertility-related problems participated in the trial.  The women ranged in age from twenty to forty-five. The study's original September 2022 deadline was pushed out to September 2023. Those persons were divided into two groups based on the anesthetic routine used for the retrieval of oocytes during general anesthesia. While remifentanil, midazolam, and propofol were given to the second group, fentanyl, midazolam, and propofol were given to the first group. Results: The current study's findings demonstrated that remifentanil increased the rate of fertilization (52.40) than fentanyl (47.87); comparing the hormonal levels in The follicular fluid showed significantly higher FSH levels in the remifentanil group (p = 0.046); on the other hand, there were no significant differences between the fentanyl and remifentanil groups regarding follicular fluid LH and prolactin levels, with p values equal to 0.632 and 0.320. According to the results, the fentanyl group showed insignificantly higher total oocyte counts (p = 0.973) and metaphase II oocytes (p = 0.495). On the contrary, there were insignificantly fewer abnormal oocytes (p = 0.919), germinal vesicles (p = 0.259), and ruptured oocytes (p = 0.406) in the fentanyl group. There were also no significant differences between the studied groups regarding total transferred embryos (p = 1.00) or grade I embryos (p = 0.739). Conclusion: Because of remifentanil's quicker recovery period and substantial association with specific IVF and ICSI characteristics, it is preferable to fentanyl when used under general anesthesia for ova collection operations.