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The egg retrieval process is a key milestone in IVF treatment – and one of the most daunting. You might worry it’ll be painful, or that you won’t get enough eggs for a successful IVF cycle.
The good news is understanding the process of egg retrieval can ease these fears and help the procedure go more smoothly.
Read on to learn everything you need to know about egg retrieval. We’ll cover what to expect, the optimal number of eggs, and things that affect success rates.
Key Takeaways
- Egg retrieval is one of the key steps in the in vitro fertilization (IVF) process.
- Before egg retrieval, a woman takes injectable hormone medications for 8-14 days. This coaxes the body to produce a large batch of ovarian follicles, which each hold an egg.
- When the follicles are mature, a fertility specialist collects the eggs during an egg retrieval procedure.
- The doctor inserts a needle (which is connected to a suction device) into each follicle. Each egg is gently pulled out. They’re then sent to a lab where they’re fertilized.
- The entire egg collection procedure only takes about 10-20 minutes.
- The woman is lightly sedated during the procedure, so she doesn’t feel any pain.
After egg collection, you may experience some cramping, spotting, or bloating. This usually passes within a few days. - In general, the more eggs retrieved, the higher the pregnancy rates. But only to a point.
- Some studies show that the live birth rate flattens between 11 to 20 eggs.
- In addition, as more eggs are retrieved, the risk of severe OHSS increases. So safety needs to be a top priority too.
- Age, lifestyle factors, and health conditions like PCOS and endometriosis can all affect the success of egg retrieval.
- To boost your odds of a successful egg retrieval, keep a healthy lifestyle and time your trigger shot right. Or consider trying a mini-IVF round.
What Is Egg Retrieval?
Egg retrieval, also known as egg collection or oocyte retrieval, is one of the steps in the In Vitro Fertilization (IVF) process. It’s a short, minimally invasive procedure that’s done in a fertility clinic or doctor’s office.
During egg retrieval, a fertility specialist collects eggs from a woman’s ovaries. These are then sent to a lab, where they’re fertilized. Any fertilized eggs that become embryos are then transferred into the woman’s womb or frozen.
Egg Retrieval Process
The entire egg retrieval procedure only takes 10-20 minutes. However, there is some prep work and recovery time involved.
Preparation for egg retrieval
To prepare for egg retrieval, you’ll take injectable hormones for 8-14 days before your procedure. This is known as ovarian stimulation. These fertility medications tell your ovaries to grow multiple follicles. Each follicle is a fluid-filled sac that holds an egg.
Your follicles are carefully monitored as they develop. Once they reach approximately 14 mm or above, they’re considered mature and ready for retrieval.
About 34-36 hours before your procedure, you’ll get a “trigger shot” of hCG (aka Human Chorionic Gonadotropin Hormone). This prepares your eggs for the collection procedure.
The procedure involves mild sedation. So you’ll be asked not to drink or eat anything after midnight the day before your procedure.
Egg retrieval procedure
Before the procedure, an anesthesiologist will give you a light sedative or mild anesthesia. This will ensure you don’t feel any pain or discomfort during the procedure.
Your fertility doctor will then insert a needle through your vagina into your ovarian follicles, guided by ultrasound. The needle is attached to a suction that carefully pulls the eggs out of each follicle. Once all the eggs are removed, the process is repeated on the other ovary.
The collected eggs are put in culture dishes. They’re then placed in an incubator until ready for fertilization.
Egg retrieval recovery
After the procedure, you’ll rest in a recovery room for about an hour. Since you’ll be coming out of sedation, you’ll need a friend or family member to drive you home.
Plan to take it easy for the rest of the day to help your body recover. If you’re feeling antsy, a gentle walk is okay. But put the chore list and intense workouts on hold for a few days.
You can return to work the day after the procedure. But if you need another day or two to rest, that’s okay! Listen to your body.
Side Effects of Egg Retrieval
After your egg retrieval procedure, you may feel soreness or cramping in your abdominal area. Other side effects may include bloating or spotting. Side effects can last for a few days and are typically mild.
Applying a heating pad or hot water bottle to your abdomen may help ease your discomfort if you’re in pain. You can also take Tylenol until the pain subsides.
Like all medical procedures, the egg retrieval process does come with some risks. The medications taken during ovarian stimulation increase the risk of ovarian hyperstimulation syndrome (OHSS).
This rare complication of IVF treatment causes the ovaries to swell and leak fluid into the abdomen. OHSS can be painful. And if severe and left untreated, it can be life-threatening.
Signs of severe OHSS include:
- Severe abdominal pain
- Rapid weight gain
- Severe nausea and vomiting
- Blood clots
- Shortness of breath
- Decreased urination
If you notice any of these symptoms after egg retrieval, contact your healthcare provider right away.
How Many Eggs Are Optimal for Egg Retrieval?
Age group | Egg retrieval | Pregnancy rate |
<35 years | 10 eggs | Good outcome |
35 – 39 years | 5-9 eggs | Best outcome |
>40 years | More eggs = higher rates | The more eggs retrieved, the higher the pregnancy rates |
In the egg retrieval process, most people assume the more eggs, the better. And in some ways that’s true. But only to a point.
One study found that the live birth rate proportionately increased when up to 11 eggs were retrieved. But once the number of oocytes hit 11, the live birth rate flattened out. And it stayed level all the way to 20 eggs.
The catch? As more eggs are collected during egg retrieval, the rate of severe OHSS goes up. This is especially true if more than 18 eggs are retrieved.
This means the number of eggs isn’t the only important factor here. Patient safety needs to be top of mind, too.
Another study showed that age also plays a role in the ideal number of eggs. Here’s what they found:
- Women under 35: Pregnancy rates didn’t improve much beyond 10 eggs.
- Women 35 to 39: Women who had between 5 to 9 eggs at retrieval had the best outcomes.
- Women over 40: The more eggs retrieved, the greater the pregnancy rates.
There are other factors besides age that need to be considered though.
Factors That Affect Egg Retrieval Success
In IVF treatment, egg retrieval is considered a success if it leads to a successful pregnancy. Here are some things that can impact the success of the egg retrieval:
Age
Age is by far the key predictor of egg retrieval success. This is because egg count and egg quality both decrease as women get older.
Plus, many women undergo hormonal shifts in their mid-30s due to perimenopause. And when your hormones are imbalanced, it can make it harder to get pregnant.
The Society for Assisted Reproductive Technology (SART) shares an annual report with IVF success rates. Here’s what the 2021 data showed:
Age | Live birth rate per egg retrieval (for all embryo transfers) |
Under 35 | 44.5% |
35-37 | 32.4% |
38-40 | 20.2% |
41-42 | 9.6% |
Over 42 | 2.9% |
If any of these stats are disheartening, don’t lose hope. Focus on what you can control. Take good care of your body so you’re as healthy as possible (more on this later).
Coexisting conditions
Certain health conditions can also affect the success of IVF fertility treatment, including:
PCOS
Polycystic ovarian syndrome (PCOS) is a hormonal imbalance marked by high levels of male hormones (androgens). This can lead to ovulation issues and make it more difficult to conceive.
Women with PCOS often have lower egg quality. This can reduce fertilization and implantation rates and increase the risk of early pregnancy loss.
Women with PCOS also tend to be more sensitive to ovarian stimulation. Meaning, it’s easier for them to obtain more eggs. The downside of this is that as more eggs are retrieved, the risk of OHSS and thrombosis goes up.
That’s why doctors often give patients with PCOS a milder ovarian stimulation protocol. Lower doses of meds reduce the number of eggs retrieved – but also lower any potential risks.
Know more: What is the Best Age to Get Pregnant With PCOS?
Endometriosis
Endometriosis is a medical condition where uterine tissue starts growing outside the uterus. This can lead to scar tissue, pelvic pain, and infertility issues. And for some women, it can affect their response to IVF.
Research shows women with severe endometriosis who undergo IVF have far fewer eggs retrieved.
Surgical treatment for endometriosis can also damage ovarian reserve. This can reduce the number of eggs available at retrieval.
Know more: Getting Pregnant with Endometriosis: Success Stories
Lifestyle factors
Lifestyle habits like smoking, chronic stress, and poor diet can also affect egg quality. And poor egg quality affects embryo quality, which can reduce your chances of IVF success.
Know more: IVF Sucess Rate: Factors That Affect Your Chances
How To Increase Your Chances of a Successful Egg Retrieval
When it comes to IVF treatment, a lot may seem out of your control. But there are a few things that can help this process go smoothly, so you have the best chance of success:
Improve egg quality
You can improve your egg quality by making healthy lifestyle shifts like:
Eat right. Processed foods contain endocrine-disrupting chemicals (EDCs) that can affect reproduction. You can easily sidestep this by eating a nutritious fertility-friendly diet. Opt for wholesome foods like fruits, veggies, legumes, whole grains, nuts, seeds, and fish. For a deep dive on how to eat for fertility, check out this article.
Keep stress in check. Stress amps up the production of the stress hormone cortisol. This can trigger a cascade of hormonal imbalances, which can affect fertility. To keep stress at bay, carve out time for self-care activities that help you destress. Read a book, take a bath, journal, or do some yoga. Whatever helps you relax.
Exercise. Regular exercise boasts many benefits from boosting your mood to improving fertility. And you don’t need to train for a marathon to see results. Moderate exercise seems to have the most benefits. One study found women who got more than 5 hours a week of moderate exercise (walking, cycling, gardening, etc) were 18% more likely to get pregnant. But if that’s not doable for you, do what you can!
Get enough Zzz’s. Lack of sleep can disrupt hormone balance, which can impact fertility. Aim to get 7-9 hours of sleep each night.
Try CoQ10. Coenzyme Q10 is an antioxidant that helps your cells’ mitochondria make energy. Research suggests it may help women undergoing IVF who have poor ovarian response. One small study had women take a CoQ10 supplement for 60 days before starting IVF. They found that women who took CoQ10 had a better response to ovarian stimulation and higher-quality embryos than those who didn’t.
Know more: How to Improve Egg Quality: Is It Really Possible?
Time the trigger shot right
As mentioned, about 34-36 hours before your procedure, you give yourself a “trigger shot.” This helps your eggs go through the final stages of maturation so they’re ready for retrieval.
The timing is crucial here. If you give the trigger shot too early, your eggs may not be fully mature. And if you give it too late, your eggs could ovulate into your fallopian tubes and no longer be available. This would delay the egg retrieval procedure.
The best way to avoid these issues is to follow your doctor’s instructions to the T. They understand the big picture of your fertility plan timeline. So they’ll instruct you exactly when to administer the trigger shot. If you’re worried about timing it right, setting an alarm on your phone may help.
Know more: 6 Common Trigger Shot Mistakes to Avoid
Consider mini-IVF
Regular IVF | Mini IVF | |
Medication dose | ↑ | ↓ |
Number of eggs retrieved | ↑ | ↓ |
Success rate | ↑ | ↓ |
Side effects | ↑ | ↓ |
Risk of OHSS | ↑ | ↓ |
If you have a higher risk of OHSS, mini-IVF may be a good option. Mini-IVF, also known as minimal stimulation IVF, uses lower doses of fertility meds compared to traditional IVF.
Lower doses mean less risk of developing OHSS. Research shows mini-IVF can be especially helpful for women at an advanced maternal age.
One study compared pregnancy rates for 520 women with low ovarian reserve. Some went through traditional IVF, while others did mini-IVF.
They found that women under age 35 had better pregnancy rates with traditional IVF (50.2% vs 41.2%). But for women age 43 and older, pregnancy rates were four times higher (22% vs 5.5%) from mini IVF!
FAQs
The actual procedure isn’t painful at all, because you’ll be sedated. But you may feel some mild to moderate cramping afterward. This usually passes within a few days. Be sure to get plenty of rest to help you recover. Using a heating pad or taking Tylenol or ibuprofen may help ease any discomfort.
The procedure only takes between 10-20 minutes – shorter than an episode of Friends! But you’ll need to relax for the rest of the day to recuperate.
After your egg retrieval procedure, try not to overdo it. Skip vigorous exercise for a few days and rest up. This will help speed up your recovery. That way, your body will be as strong as possible when it’s time for embryo transfer.
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- IVF (In Vitro Fertilization): Procedure & How It Works
- Mature Follicle Count and Multiple Gestation Risk Based on Patient Age in Intrauterine Insemination Cycles With Ovarian Stimulation
- Ovarian hyperstimulation syndrome – PMC
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- What is the optimal number of eggs at oocyte retrieval? – Fertility and Sterility
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- National Summary Report
- The Optimal Number of Oocytes Retrieved From PCOS Patients Receiving IVF to Obtain Associated With Maximum Cumulative Live Birth Rate and Live Birth After Fresh Embryo Transfer – PMC
- Influence of Endometriosis on Assisted Reproductive Technology Outcomes
- Expectant, Medical, and Surgical Management of Ovarian Endometriomas – PMC
- Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial – PMC
- A prospective cohort study of physical activity and time to pregnancy – Fertility and Sterility
- Use of a novel minimal stimulation in vitro fertilization (“mini-IVF”) protocol for low ovarian reserve and for older women
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