Orchid offers advanced genetic testing for couples who want their child to have the best shot of a healthy life. As part of our “Pregnancy and Fertility” series, we talked with fertility nurse Cristina Vidal, RN about the egg retrieval process from start to finish.
What happens before the egg retrieval?
The 10 - 14 day period before an egg retrieval is referred to as the ovarian stimulation phase. This phase consists of several monitoring visits at the fertility clinic and daily administration of injectable hormone medications at home.
During the monitoring visits, the physician will monitor your hormone levels through bloodwork and perform ultrasounds to look at follicle growth. Checking follicle growth matters because it helps doctors estimate how many eggs can be collected.
A quick 101 on ovarian follicles: there are multiple follicles on each of your two ovaries. Each follicle typically houses an egg, and because eggs are microscopic, they can not be seen on an ultrasound. Therefore, the only option is to monitor follicle growth. As follicles grow, most of the eggs inside them are growing and maturing as well.
Monitoring visits are done in the morning (often before standard work hours) so that by the end of the day, you’ll know the date of your next monitoring appointment. Once the physician confirms your follicles are at an ideal size (usually in the 18 - 20mm range) you will be instructed to self-administer a final “trigger shot” 34 - 36 hours before the egg retrieval. The “trigger shot” is a critical component of the process because it helps the eggs inside the follicles undergo final maturation before retrieval.
Once you’ve administered the trigger shot, it’s time to mentally and physically prepare yourself. This means taking some time for self-care in the hours leading up to the retrieval. Take things easy — strenuous activities are not recommended.
You may experience bloating since your ovaries are physically bigger and heavier with multiple maturing follicles. From an emotional perspective, awareness of these physical changes can help manage temporary discomfort. Some women find it helpful to tell themselves during the process that, “I’m not quite myself right now, I know why, and I know that it will pass.” Know that everyone reacts a bit differently to stimulation medications.
Talk to your doctor about specific pre-procedure clinic instructions. Generally, do not eat or drink anything after midnight the day of your retrieval. Arrange your transportation home from the egg retrieval because you will need to refrain from driving for at least 24 hours post-procedure due to the light anesthesia. The majority of clinics require a family member or friend to accompany you and drive you to and from the clinic on the day of the egg retrieval.
What happens on the day of the egg retrieval?
You’ll want to confirm the pre-procedure protocols with your clinic. Clinics will stress the importance of arriving early because the timing of your egg retrieval is the most crucial part of this process. If the eggs are retrieved late, they could ovulate on their own. If you ovulate before egg retrieval, your eggs can’t be found or used for IVF.
Once you arrive at the clinic the day of the retrieval, a staff member will answer any last-minute questions and review steps for that day. You’ll then be brought into an operating room with your physician, anesthesiologist, embryologists and nursing staff.
You will lie on a table where IV anesthesia will be administered. The anesthesia used is not general anesthesia, but rather an intravenous sedation medication. This is called “Monitored Anesthesia Care." In general, you don't feel any pain, but may experience a little discomfort, and you won't remember the actual procedure.
Once under anesthesia, the physician will begin the procedure by using a transvaginal ultrasound probe to guide the needle, through the vaginal wall, into each ovarian follicle. There is typically only one puncture into each ovary but within each ovary are multiple follicles that each house an egg (although it is possible some follicles do not have an egg or a mature egg). Each egg, along with the follicular fluid, is gently aspirated through the needle and into a test tube. These test tubes are handled by highly-trained embryologists who alert the physician when an egg is found. This indicates it’s time to move to the next follicle and repeat the process. This process is repeated until all follicles (in both ovaries) have been drained. The actual egg retrieval rarely takes longer than 20 minutes.
What happens after the egg retrieval?
Immediately following the egg retrieval, you’ll be taken to the recovery area where you’ll be monitored as you awaken from the anesthetic. The clinic staff will let you know how the procedure went and how many eggs were retrieved. It’s important to note that not all eggs retrieved will be mature and frozen.
At this point in the process, you can return home. Most patients walk out of the clinic after the procedure about 1 hour later, taking the day off to rest. It is recommended to relax and drink electrolyte-rich fluids in the days following the egg retrieval. Some patients request time off work the day following the egg retrieval, but it is not required. Your clinic will give you specific instructions on post-retrieval care based on your health status and egg retrieval procedure.
Recovery of the egg retrieval procedure is brief and patients can return to routine daily activities over the next few days, usually next day. The clinic will contact you 24 hours after the procedure to do a follow up of your recovery, and also to provide the number of eggs cryopreserved or the number of embryos that were successfully fertilized.
Will I have any symptoms after the egg retrieval?
After the retrieval, it’s possible you will experience slight soreness, spotting and abdominal cramping similar to a heavy menstrual period. These effects usually subside a few days after egg retrieval. Symptoms can be relieved through over-the-counter pain relievers. If you notice heavy bleeding or significant pain that is worse than a normal period, please contact your medical professional.
Some women may be at risk of ovarian hyperstimulation syndrome (OHSS). OHSS can be largely avoided and eliminated with close monitoring and medication dosage adjustments, and increasing protein and fluid intake. Talk to your fertility doctor to see if you may be at risk.
What happens to my eggs after the egg retrieval?
- If you are freezing your eggs for future use, your eggs will be safely stored at the clinic's embryology lab until you’re ready to use them.
- If you are proceeding with IVF and plan to transfer an embryo, the embryologists will prepare your eggs for fertilization and perform all the necessary procedures behind the scenes.
Since the egg retrieval is such an essential part of the IVF process, our goal is to ensure you have a complete understanding of each step before, during and after the procedure. Consult with your fertility clinic to learn more and discuss what fertility treatments may be right for you.
- Most of the work involved in the egg retrieval process are around the two weeks leading up to the scheduled procedure.
- The actual egg retrieval is brief and most patients fully recover within 5-10 days.
- After egg retrieval, your clinic will update you on how many eggs were retrieved and cryopreserved, or how many eggs were fertilized. They will guide you on your next steps depending on your treatment plan.
- Short video describing the egg retrieval procedure
- American Society of Reproductive Medicine (ASRM) Patient Resources
- Society of Assisted Reproductive Technology (SART)
- American College of Obstetricians and Gynecologists (ACOG)
- Patient stories: one couple’s egg retrieval experience
Fertility treatment and reproductive medicine have come a long way since IVF was first introduced over 40 years ago. Orchid offers advanced genetic testing for couples who want their child to have the best shot of a healthy life. Conceive with greater confidence and peace of mind