Patient Resources

The Egg Retrieval Process: What to Expect

Egg retrieval is an important part of the in vitro fertilization (IVF) process. During the egg retrieval procedure, oocytes – or eggs – are removed from the patient’s ovaries via an intravaginal aspiration process so they can be combined with the male partner’s sperm to form an embryo that will be transferred back into the patient’s body.

If you’re scheduled for an egg retrieval procedure, you may have questions about the process and its role in your fertility treatment regimen. We understand. Read on for more information on what you can expect at every step of the egg retrieval process.

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Before the Procedure

Ten to twelve days before your scheduled egg retrieval, you will begin daily injections to stimulate ovarian follicle growth. The last injection before the egg retrieval is called the trigger shot and is just hours before the eggs would normally release.

The night before the procedure, your anesthesiologist will call to walk you through the next day’s process and remind you of the sedation protocol, including avoiding food, beverages and medications after midnight.

The Day of the Procedure

We recommend you arrive at the outpatient center one hour before your procedure is scheduled to begin. This will allow you plenty of time to complete your paperwork and consult with the nurse and physician performing the procedure.

After you change into your hospital gown and enter the surgical room, your anesthesiologist will administer light intravenous sedation. Your physician will then use an ultrasound machine and probe to locate and retrieve individual eggs from your ovarian follicles. These eggs will be transferred directly to the laboratory technicians through a secure window in the surgical room.

When this is complete, the anesthesiologist will gently bring you out of sedation and you will be transferred to the recovery room before returning home. We encourage our patients to take it easy the day of the procedure, but you are clear to return to work the following day barring any complications.

After the Procedure

Immediately after the procedure is complete, the embryologist will count the number of eggs retrieved and assess them for maturity, and if necessary, inject the viable eggs with your partner’s sperm sample or mix eggs and sperm for fertilization. The eggs will then be placed into an incubator overnight while the natural fertilization process begins.

The next steps in the process can be broken down by each day following the procedure.

Day 1

On average, 70 – 80% of the eggs should be fertilized after being injected with sperm. Your embryologist will evaluate the eggs for signs of embryo growth. Your doctor will provide you with an update on the number of eggs fertilized.

Day 2

The embryos will continue to develop in the incubator.

Day 3

By now an ideal embryo will comprise about eight cells each. Your doctor will contact you with an update after grading each embryo on the following scale:

• Good – The eight-cell embryos are symmetrical and growing at a proper rate.
• Fair – The embryos only comprise five or six cells, or are slightly irregular in shape.
• Poor – The embryos are structurally uneven or are not growing as expected.

Day 4

The embryos will continue to develop in the incubator.

Day 5

By this point, the embryos should have grown to form 100-cell embryos called blastocysts, which are again graded on growth rate and symmetry. On this day, the embryos can be frozen for future use. If genetic testing to occur, this is the first day a biopsy on the embryo can be taken. Alternatively, embryos are frozen for a subsequent embryo transfer if they are they appropriate quality. Your physician will contact you again with an updated embryo report after performing this assessment.

Day 6-7

The embryos are again assessed to see if they have continued to grow to the point of being ready for biopsy or freeze. As part of this process, a small sample of three to four placental cells from each embryo are evaluated at the genetics lab for structural balance. Your physician will call you with an update after performing this testing.

At this point, balanced embryos can be implanted back into your uterus through an embryo transfer procedure. Your physician will guide you through the next steps to coordinate the procedure.

In the event the embryos aren’t ideal for transfer, your physician will walk you through the course of beginning another round of injections to re-start the ovulation process the following month.

Additional reading: Questions about IVF Egg Retrieval