General guidelines for determining the appropriate time for retrieval are: there are at least 2 follicles 18mm or greater in size, half or more of all the follicles are at least 15mm and Estradiol levels are between 1500 and 5000. These values refer to measurements and blood levels taken on the last day of stimulation.
Despite the fact that the eggs are “ready” they are not yet truly mature. In order for each follicle of 15mm or more to produce a mature egg, a final injection must be taken. This final shot is called HCG. For the first 36 to 40 hours after the HCG shot is taken, the larger eggs will go through their final maturation process. It is essential that eggs be allowed this final maturation process. It is essential that eggs be allowed this final maturation; otherwise, they would be incapable of being fertilized. On the other hand, it is vital that not more than 40 hours pass after the HCG shot. Sometime after 40 hours, if not retrieved, the eggs will “ovulate”, that is they will be expelled out of the ovary and lost in the abdominal cavity and there will be nothing to retrieve. Thus, it is vital that the HCG shot be taken exactly as instructed. Retrieval will be scheduled 36 hours following the trigger shot.
What Actually Happens During an Egg Retrieval?
An egg retrieval typically takes place under some form of sedation, so you will not feel any pain. A needle is attached to an internal ultrasound probe, which is inserted into the vagina. The doctor uses the ultrasound to see the ovaries and locate the ovarian follicles. The needle punctures each follicle, and a gentle suction is applied to remove the egg and fluid within the follicle. An embryologist then evaluates the fluid and finds the egg. Sperm and eggs are placed together to allow fertilization to occur.
How Do I Prepare for an Egg Retrieval?
If the procedure will happen under anesthesia, you may be asked to abstain from eating or drinking for 8 to 10 hours beforehand. You will be asked to remove contact lenses, jewelry and nail polish. The anesthesiologist and/or nurse will meet with you prior to the procedure to get some basic medical information and start an IV. Once settled in the operating room, you will be given some medicine, either through the IV or a face mask, to make you go to sleep.Will the Egg Retrieval Hurt?
If anesthesia is given, you will be sleeping and not feel anything during the procedure. Afterwards, you may notice some cramping similar to menstrual cramping. The doctor may prescribe pain medication, although Tylenol (acetaminophen) is usually sufficient to relieve any discomfort.What Will I Need to Do After the Egg Retrieval?
The doctor will most likely start you on a series of medication, including an antibiotic to prevent infection, a steroid to reduce any inflammation in the reproductive organs, and hormonal supplements to provide extra support to the endometrial lining. It is important to take these medications exactly as prescribed. You may be asked to refrain from sexual intercourse for a period of time, or avoid submerging yourself in water (such as taking a bath). Use a pad, not tampons, to deal with any vaginal bleeding.Keep an eye out for the following symptoms and promptly report them to your doctor, should they occur:
- temperature above 101 F
- severe abdominal pain or swelling
- severe nausea or vomiting that doesn’t go away
- heavy vaginal bleeding (soaking through a pad in an hour; some light bleeding is normal)
- difficulty urinating, or painful urination
- fainting or dizziness
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