Egg Retrieval For IVF
• What Is Egg Retrieval?
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|Other Names: Egg retrieval is also called follicular aspiration and egg harvesting. Your doctor may refer to your eggs as oocytes.
What Is Egg Retrieval?
It is a medical procedure to surgically remove eggs from a woman's ovaries. Egg retrieval is performed as part of an IVF treatment program - either because the woman wants to become pregnant immediately, or she would like to have her eggs harvested and frozen for possible future use (see more about egg freezing). The patient will have received fertility drugs to boost her egg production so that as many as possible can be harvested in one procedure. For the purpose of this article we will focus on egg retrieval for immediate pregnancy.
Anywhere between 8 and 15 eggs is average. Remember though, it is all about quality not quantity. Not all the eggs will be fertilized, so the number of oocytes retrieved is no indication of how many embryos you will end up with.
The procedure varies from one clinic to another, but you are likely to be heavily sedated or given a general anesthetic. You won’t be conscious, so you won’t feel any pain.
You will be taken to a separate part of the clinic, which you will not have seen before. You will be given a gown, hat and shoe covers because the IVF suite is a sterile area. You will be placed on a bed and your legs put in stirrups. An IV drip will be inserted into a vein, the purpose of this is to give you medication. It also means you can be given large amounts of fluids quickly in case of an emergency. The embryologist (doctor who handles embryos) may make a brief appearance to ask you to confirm your name, partner's name and social security number. This ensures no mix up of sperm and eggs occurs. Next your doctor will arrive, you may already have been given your sedation. He will insert a speculum into your vagina and wash the area thoroughly to kill any germs. Retrieval is usually done using a vaginal ultrasound probe. A needle and separate hollow tube is attached to the probe. The doctor pushes the needle through the wall of the vagina to reach the ovaries. He uses the probe to locate the follicles containing the eggs (the probe is pressed against the vaginal wall, stretching it closer to the ovaries, but it does not tear through the wall). The needle punches a hole in the first follicle. The egg and surrounding fluid is sucked out of the follicle, through the hollow tube and into a test tube. This is repeated for each ripe follicle. The fluid collected is given to the embryologist. He will examine it under a microscope to determine how many eggs are present (he will know by the time you wake up). He will also grade the eggs according to quality. When all the follicles are empty, you will be woken up and returned to a bed to recover. The whole procedure takes about 40 minutes.
While you are undergoing egg retrieval your partner will be asked to provide a fresh sperm sample. If you are using sperm donation, your clinic will thaw the sperm to coincide with your retrieval.
You will feel groggy after your sedative and your tummy may be sore and swollen. This should pass within a day and you can return to normal activity. There is a small risk of hyperstimulation (OHSS) if a large number of follicles were emptied and fill up with water (cysts). Signs of OHSS include severe bloating above the belly button and reduction in urination. See, ovarian stimulation for more details.
Your doctor will probably give you some antibiotics to take for a few days after retrieval. If you are prone to yeast infections you can take an over the counter remedy called acidophilus at the same time to help prevent it.
Clinics vary on their approach to anesthesia for follicle aspiration. Larger clinics perform the procedure in a hospital operating suite in the presence of a nurse anesthetist or anesthesiologist (a doctor who specializes in giving anesthesia). Smaller clinics may only have a regular nurse or doctor giving the medication. Some centers offer a choice of anesthesia, from conscious sedation (induces light sleep) to general anesthesia (deep sleep). With conscious sedation you receive some form of valium medication and a narcotic like morphine. When you wake up you the first question you are likely to ask is, ‘how many eggs did you get?’ Don’t be surprised if you need to ask two or three times before you are conscious enough to remember the answer!
Yes, bright red vaginal spotting for 24 to 48 hours after retrieval is normal. It is caused by puncture wounds to the vagina. If bleeding develops contact your doctor immediately.
• Rest as much as you can in preparation for receiving your embryos. Rest will aid healing and recovery.
They will be fertilized with your partner's (or donors) sperm. Fertilization protocols vary from one clinic to another. Usually the sperm are prepared (washed) and combined with your eggs and a culture liquid in a shallow dish (alternatively you can pay more to have the sperm injected directly into the egg to increase the chance of fertilization. This is done by ICSI procedure). They are incubated for 18 hours at 37 degrees. After this, they are examined to see if fertilization has occurred. Within another 24 hours, the embryos will have grown and will be ready for transfer. There are several additional options at this point you can choose. Assisted hatching is where the embryologist punctures a whole in the shell surrounding the embryo, so it can break out more easily when placed in the womb. Or you may be offered a blastocyst transfer - read more about day 5 embryo transfer.
Next: Embryo Transfer
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