What Is the Egg Retrieval Process Really Like?
We spoke with experts and patients to learn what to expect when retrieving your eggs, whether you intend to freeze them or undergo in vitro fertilization (IVF).
While the process of retrieving eggs from your ovaries may seem intimidating, it’s actually a fairly common procedure with minimal side effects. Most women retrieve eggs for one of three reasons:
They’re undergoing in vitro fertilization (IVF), a fertility treatment that involves retrieving eggs from the ovaries, inseminating them with sperm, and inserting the fertilized embryo into the woman’s uterus.
They’re freezing eggs for later use. Alternately, they could freeze embryos (eggs fertilized with sperm). Women/couples often freeze eggs when they aren’t ready to have a baby yet, but they’re worried about diminishing egg quality or quantity.
They’re donating eggs to another woman/couple.
No matter the reason for egg retrieval, the process follows the same basic timeline: The woman prepares by taking fertility-boosting medications for about two weeks, heads to the hospital for a surgical procedure to retrieve the eggs, then spends one day recovering. Here’s everything you need to know about the egg retrieval process.
How to Prepare
During ovulation, your ovaries release one mature egg into the fallopian tube, where it awaits fertilization with sperm. But with egg retrieval, doctors try to gather as many mature eggs as possible during one ovulation cycle. “We’re saving some of the eggs that would otherwise have died,” says Lauren Roth, M.D. a board-certified ob-gyn and reproductive endocrinology and infertility specialist with Shady Grove Fertility.
So how do you get the ovaries to develop more than one mature egg? To start, a woman undergoes testing to determine her egg count. This usually happens on the second or third day of the menstrual cycle. “We analyze hormone levels in the blood and ultrasound findings on the ovaries,” says Dr. Roth. “This allows the doctor to make a medication protocol specific to that women so we can try to get as many eggs to develop in unison as possible.”
Next, the woman takes injectable fertility medications to make enough hormones for multiple eggs to develop. She usually injects these medications herself for one-and-a-half to two weeks, says Dr. Roth. Doctors will monitor her response to the medication with ultrasounds and blood work. When enough ovarian follicles (fluid-filled sacs) develop mature eggs, the woman takes one last “trigger shot” 36 hours before retrieval, which encourages the body to release the eggs.
In about one-third of women using stimulation medications, hormonal fluctuations can cause side effects like headaches, mood swings, insomnia, hot or cold flashes, breast tenderness, bloating, or mild fluid retention, according to Josh Klein, M.D., co-founder and reproductive endocrinologist at Extend Fertility. He says the injection site might also become sore, red, or slightly bruised.
While rare, the hormonal injection may also lead to ovarian hyper stimulation syndrome (OHSS). This causes ovaries to swell, leading to abdominal pain, bloating, nausea, weight gain, and other unpleasant symptoms. According to Mayo Clinic, about 1 to 2 percent of women with OHSS develop severe complications like blood clots, kidney failure, ruptured ovarian cysts, and death. Watch out for these symptoms during and after your use of the injections.
How Egg Retrieval Works
Egg retrieval involves a surgical procedure with a mild sedative (called twilight anesthesia) given through an IV. “The woman will breathe on her own throughout the surgery, but she won’t remember or feel anything,” explains Dr. Roth.
After she’s sedated, the woman’s legs are placed in a stirrup and surgeons conduct a vaginal ultrasound. They’ll insert a needle through the vaginal wall into the ovary. “The needles go into each ovarian follicle and use gentle suction to pull out the fluid and the egg that comes with it,” says Dr. Roth. “Doctors give this fluid to the embryologist, who can immediately tell how many eggs they're getting.” (Typically, doctors harvest about 15-20 eggs. It’s estimated that 80% of retrieved eggs will be viable, according to Extend Fertility.)
The woman wakes up about 30 minutes later, recovers for one-two hours at the healthcare center, then heads home to rest. Since driving isn’t advised for 24 hours, a friend or family member usually escorts her home. Dr. Roth says most patients can return to work the next day, although they may experience minor side effects. There are no scars or stitches required for the surgery.
Possible Side Effects
After egg retrieval, the most common side effects are constipation, bloating, cramping, spotting, and pain. “You may have pain because egg retrieval is a surgery. The ovaries are much bigger than normal from the medication, and you place a needle into them,” explains Dr. Roth.
Some patients also have a negative reaction to the anesthesia, which comes with symptoms like fatigue, nausea, and vomiting. And although rare, you could experience bleeding, infection, and damage to the surrounding organs. “Luckily these severe complications are all very rare because the procedure is guided by an ultrasound,” says Dr. Roth. Call the doctor if you experience vomiting, intense pain, or severe bloating following egg retreival.
The Egg Retrieval Process IRL
We asked women who’ve been through it to share their experience before, during, and after egg retrieval. Here’s what they had to say.
How did you prepare for egg retrieval?
Claire Wasserman, founder and director of programming at Ladies Get Paid, retrieved her eggs through Extend Fertility. She first attended a workshop about the process, which included training on how to inject her two fertility medications. Then she visited the clinic one day after her period began to get blood work and an ultrasound. She returned for five additional visits, during which doctors measured her follicles and conducted blood work to check estrogen levels. “Halfway through, they gave me a third medication, called an antagonist, which prevented any one particular follicle from dominating, as well as stopping any ovulation,” she says. “When they decided my follicles were large enough, they added a fourth medication called ‘the trigger shot,’ which kickstarted the maturity process and gave us a 36-hour window before retrieval.”
Every woman has her own way of preparing for the procedure mentally and physically. Take Hillie, a Chicago-based woman in her mid-30s who retrieved and froze her eggs. “For me, it was about consistency for my mental and physical space. I talked to a therapist – someone outside the realm of my friends, who didn't fully understand what I was going through,” she says.
Were the fertility injections painful?
“Injecting myself with hormones didn’t feel great, but honestly, stubbing your toe is worse,” says Claire. “I definitely experienced mood swings and bloating but nothing too much worse than having PMS.”
Hillie said giving yourself shots is a daunting process, but not painful. "The needles aren't particularly big, and you're injecting into your stomach for the most part," she says. "Its a little surreal and a little weird to be giving yourself so many shots so often, but it didn't actually hurt.”
What did you eat before egg retrieval?
Kacey, a 30-year-old woman from Connecticut, has donated eggs five times since she was 25 years old. Right after starting her fertility medication injections, she begins following a high-protein and low-carb diet. “I do this to reduce my risk of OHSS after my retrieval,” she says. “I also drink a lot more water with electrolytes.”
But following a specific diet isn't necessary. Hillie, for example, simply focused on healthy eating and exercise.
Keep in mind that patients shouldn’t eat or drink anything the night before the surgery.
Is egg retrieval painful?
Egg retrieval is a short procedure. Hillie says her surgery took 24 minutes – "but I think most people are done in 15-20 minutes," she adds. However, Hillie experienced some slight discomfort after surgery, including bloating and fullness. “You're stimulating your follicles to get as many eggs as possible," she says. "Most months your follicles only release one mature egg," so you can expect more symptoms with this procedure.
Out of her five egg retrievals, Kacey says only one caused significant pain. “My most recent donation was the only time I required a pain medication stronger than Ibuprofen,” she says. “More than 50 eggs were retrieved, which I think had a lot to do with the tougher recovery.”
What can you expect after egg retrieval?
Kacey describes her pleasant experiences after egg retrieval: “Recovery has always been easy for me. Generally I spend the day of retrieval on the couch, but I am back to my normal routine the next day,” she says. Claire also says she fully recovered after a “good night’s sleep.”
Hillie says her post-retrieval experience also wasn't bad, but she had a few days of prolonged bloating, fullness, and overall discomfort. “Many doctors say you can return to work the next day, but I recommend taking the day off to rest,” she says.
Do you have any advice for a woman getting her eggs retrieved?
Kacey urges women to do their research before undergoing egg retrieval. “When I started as an egg donor, I was not fully aware of what the medications could do to my body and the risk I was taking in my fertility and health. I’d ask patients to research their clinics, talk to women who have done this previously, look up the side effects of the medications you are taking, and don’t be afraid to ask any questions. It’s your body and it deserves to be treated kindly and with respect.”