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Egg retrieval is one of the most critical parts of the IVF process. After all, before you get to fertilization or embryo transfer, you need healthy eggs to start with.
And most medical experts agree that the number of eggs retrieved plays a role in the overall success rate. (Generally, this number will decrease as you age.)
But with in vitro fertilization, there are lots of other factors involved too. So getting pregnant boils down to a lot more than just the number of eggs you’re working with.
We want you to have the full picture of how the amount of eggs retrieved factors into your chances of conception though. So that’s exactly what we have in store for you in this article.
Key Takeaways
- The egg retrieval procedure is one of the beginning stages of the IVF process. It’s also a really important part of the entire IVF treatment. This is because you’ll need healthy eggs before proceeding with fertilization.
- Research shows that increased maternal age can lead to fewer retrieved eggs. But a woman’s age is only one factor that contributes to how many eggs are retrieved.
- Lifestyle factors, your remaining healthy eggs, and underlying health conditions play a role too.
- The amount of eggs retrieved plays a part in your chances of getting pregnant in an IVF cycle. This is because more healthy eggs = higher chance of fertilization = higher chance of pregnancy.
- Some research shows that at around 18 to 20 eggs retrieved, live birth rates are no longer positively affected. And in some cases, these higher retrieval numbers are associated with higher risk of OHSS.
- Before an egg retrieval, there are tests you can have done to predict how many healthy eggs you have left. This includes checking your FSH, AMH, estrogen, and your antral follicle count (AFC).
- If you have concerns about your egg retrieval numbers, there are a few steps you can take. Try to improve your overall health to boost egg quality. Follow your hCG trigger shot directions carefully. And consider undergoing mini IVF instead of a conventional IVF cycle.
What Is Egg Retrieval?
The egg retrieval, aka the oocyte retrieval, is one of the earlier steps in an IVF cycle.
During IVF, a woman’s eggs are taken from her ovaries. This is, of course, timed within the menstrual cycle to ensure the follicles are at the right maturity level.
Afterward, an embryologist will supervise the eggs as they are checked for maturity. The ones that are deemed suitable will then undergo fertilization. And then from there, they will hopefully become fertilized eggs and grow into high-quality embryos.
But before we get too far ahead of ourselves here, let’s tackle a common question that comes up at this point. What is the average egg retrieval count? We’ll spill all the tea on this next!
Average Number of Eggs Retrieved (IVF) by Age
Age is certainly not the end-all-be-all when it comes to IVF and getting pregnant. But research does show that a woman’s ovarian reserve naturally declines with age. This means that both the overall amount and the quality of oocytes decrease.
One study followed 3,412 fresh embryo transfer cycles to get a glimpse at egg retrieval numbers by age. Here’s what they found:
Age (in years) | No. of oocytes retrieved per cycle (Mean and range) |
<30 | 18.5 (8.2 – 28.8) |
30-35 | 15.4 (5.8 – 25) |
36-37 | 13.0 (3.8 – 22.2) |
38 | 11.0 (2.4 – 19.6) |
39 | 9.8 (3.1 – 16.5) |
40-44 | 8.2 (1.5 – 14.9) |
≥45 | 4.5 (2.2 – 6.8) |
As you can see in the table, as age trends upward, there are fewer eggs retrieved. But there’s still a relatively wide range in the number of eggs retrieved at least up until age 44.
Concerned about what these numbers mean in terms of pregnancy chances? Don’t worry, we’ll explore that relationship next.
Do More Eggs Mean Higher IVF Success Rates?
Yes, for the most part, a higher number of eggs leads to an increased chance of IVF success. This is mainly because when there are more eggs, there’s an increased number of opportunities to get chromosomally normal embryos.
But researchers are finding that the egg retrieval number only matters up to a point. Beyond a certain number of eggs, IVF success rates by cycle start to plateau.
And keep in mind, regardless of the egg retrieval number, not all eggs (even healthy ones) will become fertilized eggs. And not all embryos (even healthy ones) will implant. There are a lot of factors, including natural selection, that play a part in this.
Know more: IVF Funnel: Why Not All Eggs Become Embryos
Now, let’s see what current research says about the importance of egg retrieval numbers.
Study and purpose | Findings |
One group of researchers looked at over 400,000 IVF cycles to see the implications of egg retrieval numbers. | The ideal number of eggs for achieving a live birth is around 15. At 20 eggs and beyond, they saw the live birth rate actually steadily decline. Due to a higher risk of ovarian hyperstimulation syndrome (aka OHSS), a moderate medication protocol is the best route. |
A study of nearly 78,000 fresh IVF cycles looked at egg retrieval numbers and live birth rates. | Live birth rates were only enhanced up to 11 eggs retrieved. At 20 eggs, the live birth rate plateaued. When more than 18 oocytes were retrieved, the chance of developing OHSS increased. Somewhere between 18 – 20 eggs, there’s a trade-off between the effectiveness of treatment and patient safety. |
A study of 1,615 fresh IVF cycles examined the number of eggs retrieved and its effect on the rate of pregnancy. | The direct correlation between number of eggs and pregnancy rates was mainly seen in women aged 40 and older.
For women aged 35 – 39, the best pregnancy outcomes were seen with a modest 5 – 9 eggs at retrieval. |
As you can see in these three studies, the number of eggs collected does matter to an extent. But once a certain number of eggs is reached, there may be no additional benefit. In fact, there could even be some added risks (like ovarian hyperstimulation syndrome) when there are too many eggs.
With all this research in mind, you may be itching to know: is there a way to know how many eggs I’ll get before undergoing the retrieval?
And the answer is, yes! We’ll go over this next.
Tests To Predict the Number of Eggs That Will Be Retrieved
The number of healthy eggs a woman has at any given point is called her ovarian reserve. And while there’s no way to determine this exact number, ovarian reserve testing can help at least predict your healthy egg count.
There are four main tests that are used to do just that. But before testing, it’s a good idea to check with your doctor to see which tests are the best option for you.
Learn more about each testing method below:
1. Anti-Müllerian hormone (AMH)
AMH is one test that can help estimate how many healthy, immature eggs you have left. In general, if you have a higher AMH level, you have a higher number of healthy eggs.
Low AMH levels could mean you’ll have a poor response to ovarian stimulation. But what’s considered “low” AMH varies by age. Read the article below to learn what’s considered “low” for different age groups.
Know More: Does Low AMH Reduce My Chances of Pregnancy?
2. Follicle-stimulating hormone (FSH) levels
Testing for the amount of FSH on menstrual cycle days 2 through 5 helps predict your egg reserve. Usually, FSH higher than 10 IU/L indicates a potentially poor response to ovarian stimulation.
Know More: Boost Your Ovarian Reserve: How to Lower High FSH Levels
Estradiol
Estradiol is one of the types of estrogen found in a woman’s body. On its own, knowing your estradiol levels isn’t all that helpful for predicting your ovarian reserve. But it’s a helpful piece of information for accurately interpreting your FSH results.
In most cases, your basal estradiol value should be below 60–80 pg/mL. If your levels are higher than that, it could negatively affect your FSH levels. It could also suggest diminished ovarian reserve.
Antral follicle count (AFC)
Your antral follicle count tells you how many total follicles measure between 2–10 mm. If you have less than 5–7 follicles, you may be considered to have a low AFC. It’s also possible that you’ll respond to ovarian stimulation. Getting your AFC will require you to undergo a transvaginal ultrasound.
Now, your healthy egg supply isn’t the only factor involved in your egg retrieval success. There are quite a few additional factors at play which we’ll review next.
Other Factors Affecting the Success of Egg Retrieval
So far, we’ve talked about how age and your ovarian reserve play a role in successful egg retrieval.
But here are some other key pieces of the fertility puzzle:
- How your body responds to medication that stimulates the ovaries
- Whether or not you have health conditions like polycystic ovary syndrome (PCOS) or endometriosis – these conditions can affect the quality of your eggs as well as your retrieval success rate
- Certain lifestyle habits – poor diet, unhealthy stress levels, lack of exercise or sleep, and other habits may indirectly affect your amount of high-quality eggs and your ability to conceive
You’re not alone in feeling intimidated by all these factors. But the good news is, there are some steps within your control to boost your chance of success.
How Can You Increase Your Chances of a Successful Egg Retrieval?
1. Focus on improving your egg quality
First things first: egg quantity is less important than egg quality. So if you get a low amount of eggs at your retrieval, don’t lose hope! Chances are, you can still get pregnant. But you’ll want to be sure to do what you can to improve your egg quality.
To improve your egg quality, consider:
- Adding more sleep and exercise to your daily routine as well as eating well and reducing stress.
- Taking CoQ10. According to one study, taking CoQ10 for 2 months improved the ovaries’ response to stimulation as well as embryo quality.
Read more: How to Improve Egg Quality: Is it Really Possible?
2. Time your hCG trigger shot right
It’s critical to follow your doctor’s instructions on using the hCG trigger shot to a tee. Taking the shot too early or too late impacts the timing and success of your egg retrieval.
You will likely be instructed to take your hCG trigger shot about 34-36 hours prior to your retrieval procedure.
If this is your first time taking the trigger shot, do what you can to understand the process ahead of time. This can help better prepare you for the injection and lower your chances of doing it incorrectly.
Read more: hCG Trigger Shot Mistakes
3. Opt for “mini” in vitro fertilization (IVF)
Mini IVF is pretty much the same as regular IVF with one exception. It ensures that a lower dosage of fertility medications is used. This can be especially helpful for women who have a higher risk of OHSS.
One study of women undergoing mini IVF vs. conventional IVF found the following:
- Women aged 35 or younger saw better pregnancy results than the women in the conventional group (50.2% vs 41.2%)
- Women aged 43 or older saw improved pregnancy results with mini IVF vs. conventional IVF (22.0% vs 5.5%)
Read more: Mini IVF: Success Rates, Side Effects, and More
Keep in mind that the egg retrieval process is only one stage of IVF. Try to focus on your unique situation. And consult your doctor or fertility specialist as needed. They can help you determine what’s the best plan of action for you.
FAQs
There’s no age limit for being able to do an egg retrieval. But different fertility clinics may have different recommendations and requirements for the procedure.
There have been women in their 50s who have had successful IVF cycles. So don’t lose hope if you’re feeling like your age will be a deterring factor.
The best live birth rates with IVF seem to be when around 11 – 15 eggs are retrieved. Around 20 eggs, the success rates seem to plateau or even decline.
And for women between ages 35 and 39, a modest 5 – 9 eggs proved to be the ideal range for the best pregnancy rates.
There’s technically no limit to the amount of egg retrievals you can have done. But realize that the retrieval is a somewhat invasive procedure that involves anesthesia. It’s best to consult with your doctor about how many retrievals are right for you.
Yes, you can. According to one study, there’s no evidence that the time between egg retrievals affects your overall success rate. This means you can spread out your egg retrievals as little or as much as feels right for your circumstances.
You can even do 2 egg retrievals within the same menstrual cycle. This is called duo stimulation, or duostim for short. But it’s a relatively newer approach, so there’s not much research yet on its effectiveness.
Was this article helpful?
Ovarian hyperstimulation syndrome: pathophysiology and prevention – PMC
Female aging and reproductive outcome in assisted reproduction cycles – PMC
What is the optimal number of eggs at oocyte retrieval? – Fertility and Sterility
Live-Birth Rate Associated With Repeat In Vitro Fertilization Treatment Cycles | Neonatology | JAMA
Duo stimulation for IVF treatment – Cambridge University Hospitals
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