An egg retrieval is a simple, outpatient procedure that collects the eggs developed during ovarian stimulation. While you are sedated, the clinician will use an ultrasound to guide a thin needle through the wall of your vagina to each ovary and into each of your mature follicles to draw out the fluid inside. That fluid contains your eggs!
The entire egg retrieval procedure usually lasts between 10-30 minutes. The sedation used for the procedure helps you relax and relieves any pain or discomfort you might otherwise feel. While you may feel some mild pain and cramping afterward, over-the-counter medications such as Tylenol should help to relieve the pain.
Clinicians have a range of sedatives and anesthetics to choose from to keep you safe and comfortable during egg retrieval. If you put these medications on a spectrum – with absolute alertness at one end and general anesthesia at the other (in which you are completely unconscious and need breathing support) – the types of anesthesia used during egg retrieval fall in the middle, where you are deeply relaxed, feel no pain, and can breathe on your own. They include:
Also known as “minimal sedation” or “light sedation,” this combination of medications includes an anesthetic to relieve pain and a mild sedative that relaxes you while still allowing you to respond to questions, follow instructions, and remember what happened. The medications may be delivered intravenously (through an IV) or by mouth. Conscious sedation allows you to more quickly recover and return to your normal activities.
Also known as “monitored anesthesia care,” this type of sedation offers greater pain relief while still allowing you to respond minimally to instructions. Medications will be delivered through IV.
During this type of sedation, you are more deeply asleep and will remember little to none of the procedure.
The anesthesia medications used during egg retrieval will vary depending on what your clinic commonly uses as well as any allergies or medical conditions you have alerted your medical team to. The medications most likely to be used may be one or a combination of propofol, fentanyl, and/or midazolam.
This medication is both a sedative and an anesthetic. It takes effect very quickly, within 15-30 seconds, and will put you in a drowsy to semi-conscious state.
This medication is used primarily for pain relief.
This medication is a sedative that relieves anxiety and allows you to forget what happened during the procedure.
Regardless of what your clinician chooses, a nurse anesthetist or anesthesiologist will monitor your blood pressure, heart rate, breathing rate, and blood oxygen level continuously throughout the procedure and may administer more medication if necessary. You may also have an oxygen cannula or mask to give you extra oxygen.
Some possible side effects and risks of sedation include dizziness, nausea, vomiting, headache, and even an allergic reaction. However, these are rare.
If you are concerned about the type of anesthesia used during the procedure, you can absolutely ask beforehand to see what kind of anesthesia is commonly used at your clinic and whether they have alternatives available.
Yes, you can choose to do egg retrieval without anesthesia. Some reasons why you might opt out of anesthesia include fear of anesthesia, the added cost of medications and an anesthesiologist, or the recovery time necessary after being sedated. If any of these concerns apply to you and are a reason why you’re considering opting out of anesthesia, you should talk to your clinician well in advance of the procedure to discuss your options.
Undergoing egg retrieval without anesthesia can be very painful and the vast majority of patients choose anesthesia because of this. Still, in one study, patients who chose to undergo the procedure without anesthesia reported a high level of satisfaction from the experience (1). No matter what, it’s important that it is a choice that you make, especially in coordination with your fertility care team, who can ensure that you are otherwise comfortable during the procedure.
Below is a general sense of what you can expect before, during, and after the procedure. Your clinic’s instructions may vary from these!
Before you get to the clinic, your clinician may instruct you to stop eating and drinking (the time when they suggest you stop will vary according to the clinic).
When you get to the clinic, a nurse will review the procedure with you and ensure that your medical history is correct, you have fully consented to the procedure, and that you understand your post-operative instructions.
You will put your personal belongings – including jewelry, contact lenses, your watch, hair bands, and anything else external on your body – into a locker and change into a surgical gown. You will be shown to a private area where, if you are getting IV medications, the anesthesiologist will place an IV into your hand or arm.
If you have a partner who is providing fresh sperm for fertilization, they will be shown to a room where they can collect the sperm specimen while you are undergoing the egg retrieval procedure. While you will still hear about mature eggs on the day of, news about fertilization and embryo growth will come later.
When it is time for the procedure, you will either walk or be rolled into the procedure room and get onto a table similar to the one used for gynecological examinations. Then the anesthesiologist will administer the medication. You should have little to no memory of the procedure, which should be pain free.
When you wake up about 10-30 minutes later, you will be in the recovery room. You will have some time to recover, drink some water or juice, and eat a light snack before changing back into your clothes.
The anesthesia medications are considered safe and wear off within an hour. Still, you should plan to have someone take you home from the procedure, rest for the remainder of the day, and not drive for 24 hours.
Either prior to leaving the clinic or later in the day of your procedure, you should hear from the clinic how many mature eggs were retrieved.
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