Egg retrieval day—it’s a huge milestone. After plenty of injections, ultrasounds and bloodwork this is it. Going into your first egg retrieval can be intimidating. As an IVF nurse who has assisted in these procedures many times, and as an egg donor who has personally had six egg retrievals myself, I‘m here to help ease your worries and answer your questions about egg retrieval day.
How do you prepare for egg retrieval?
Preparing for egg retrieval can include a few different steps, depending on your protocol and personal fertility issues—but taking a good prenatal for at least three months prior to retrieval can make a big difference. The last phase prior to the procedure involves a trigger shot (read more about the trigger shot here), which typically happens around 36 hours before your egg retrieval. Other prep steps can include stopping certain medications or activities leading up to the day. Make sure to clearly understand your doctor’s instructions leading up to your egg retrieval to prepare.
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What happens on the day of egg retrieval?
On the day of your retrieval, you’ll be asked to arrive about 45 to 90 minutes prior to the scheduled procedure time. Don’t wear any perfume, jewelry, makeup or use anything scented—your team wants to ensure that the procedure takes place in an extremely controlled environment and air purity is critical for good lab outcomes. In some IVF clinics there might be an anesthesiologist to manage your procedure, while in other clinics it might be an experienced nurse who will go over your medical history with you and review consent. The nurse or anesthesiologist will then place an IV which is used to have direct access to administer medications.
Egg retrieval is typically done under sedation. In the U.S., this is often in what’s called “twilight sedation” (it feels like a quick nap and you can breathe on your own) and in Canada it’s often “conscious sedation” (where you’re sedated but awake). At this point you’ll likely review the treatment plan with your doctor. You will be asked to empty your bladder (this makes the procedure easier for your physician performing the retrieval) and change into surgical attire. The nurse will then walk you to the sterile operating room. In the room there will be the doctor, an embryologist, a nurse or medical assistant and sometimes an anesthesiologist. They will do what’s called a surgical “time out” and confirm your name, date of birth and once again go over the retrieval and treatment plan with you. Then the anesthesiologist will administer the medicine through the IV and within a few minutes you will start feeling sleepy.
What happens during the actual egg retrieval?
The doctor will insert a transvaginal ultrasound probe into the vagina—this is the same as the one that’s performed routinely during your ovarian stimulation. This helps provide real-time imaging to guide the procedure. Using ultrasound guidance, the doctor will insert a thin needle through the vaginal wall and into the ovaries to drain the follicles and collect all the eggs. The needle is attached to a needle guide on the ultrasound probe and a suction device, which will gently remove the fluid from the follicle. The doctor will drain every follicle in hopes that there are mature eggs in them. It’s important to remember that you can’t see eggs on an ultrasound since they are microscopic, and only the embryologists who uses a microscope can confirm if the drained fluid from the follicles have an egg or not.
The fluid from the follicles are collected in a test tube filled with culture media, normally composed of glucose, pyruvate, and lactate, similar to the fluid normally found in the female fallopian tubes. The culture media helps keep the eggs safe while they are taken to the lab. The nurse will carefully pass the test tubes with eggs in them to an embryologist who will look at the fluid under a microscope and count the number of eggs retrieved and assess their maturity. Depending on the treatment plan the embryologist will either freeze the eggs or attempt to fertilize them with sperm via IVF or intracytoplasmic sperm injection (ICSI). The egg retrieval is surprisingly quick—it normally takes about 15 to 30 minutes, depending on how many follicles there are and how straight forward the anatomy is.During egg retrieval, your nurse (that’s me!) will first and foremost be making sure you are safe and comfortable. The nurse will be monitoring your heart rate, oxygen level and blood pressure. They will also be assisting the doctor with the procedure. They will be handing them instruments, passing test tubes to the embryology team and documenting the procedure. After the procedure is complete your nurse will bring you to the recovery room where the effects of anesthesia wear off fairly quickly.
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Is egg retrieval painful?
Ideally during the procedure you will not feel any pain because of the anesthetics administered. Your level of sedation will dictate how much discomfort you will feel or not during the procedure. You may feel some pain after the procedure, though. It’s often described as very similar to period cramps and normally resolves with rest or a heating pad.
What does egg retrieval recovery look like?
After the procedure is complete, you will be monitored for a short period of time to make sure you are recovering well. They will provide you with a drink and a snack to make sure you can tolerate food and liquids. You may experience some cramping or discomfort afterward, but it should subside within a few days—a heating pad will be your best friend. You’ll be able to go home the same day and can generally return to your normal activities within a few days. It’s important to listen to your body and take it easy until you feel healed, as everyone recovers differently. Your period will normally start seven to 14 days after retrieval and most people say they feel 100 percent back to normal by then.
It's important to speak to your clinical team and understand which support medications you can safely take to help further decrease any unwanted side effects such as pelvic pain, bloating and nausea.
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When will you get an update post-egg retrieval?
You should know the n umber of eggs retrieved relatively soon, and certainly before you leave the clinic. If your treatment plan is to inseminate the eggs to generate embryos, then the IVF lab will keep you informed of their progress along the way.
Some labs will call you daily after the procedure with these updates. Other labs may wait to call you until the end of day seven with the final number of embryos and their grading.
