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reproductive medicine
Egg retrieval
This is the stage at which we collect the matured oocytes. Under ultrasound guidance, a very thin needle is inserted through the vaginal wall to reach the ovary and pierce the follicles one after the other. The fluid in the follicle containing the egg is then aspirated and collected in test tubes. Immediately afterwards, the follicular fluid is handed over to the embryologist, who inspects it under the microscope to confirm the presence of oocytes.
What is egg retrieval
This is the stage at which we collect the matured oocytes. Under ultrasound guidance, a very thin needle is inserted through the vaginal wall to reach the ovary and pierce the follicles one after the other. The fluid in the follicle containing the egg is then aspirated and collected in test tubes. Immediately afterwards, the follicular fluid is handed over to the embryologist, who inspects it under the microscope to confirm the presence of oocytes. Then the embryologist washes the eggs and places them in a special medium warmed up to body temperature. The collected oocytes are evaluated for quality, and if they are mature, the next steps to fertilisation are taken.
Meanwhile, in the Andrology lab, the semen produced by the male partner is prepared. A semen analysis is done, and sperm are processed using different methods to purify and activate them.
Before egg retrieval: Do not forget!
Please remember to read carefully and fill in all the necessary forms you received at the clinic’s Manipulations office, together with your partner: informed consent declaration for the medical procedure, pre-anaesthesia questionnaire, informed consent declaration for embryo or egg freezing.
Prepare your HIV, syphilis, and hepatitis B and C test results (for both partners), and do not forget that their validity is no more than three months before the date of your procedure.
Complete blood count and coagulation profile (only for the female partner) done no earlier than six days before the date of egg retrieval;
You will be informed about the date of your oocyte retrieval at least two to three days in advance, so please plan your schedule carefully. Most importantly, calculate and strictly observe the period of sexual abstinence (two to five days) required before producing the semen sample on the day of the retrieval. We advise that your partner consult a biologist from the Andrology lab about the optimal duration of abstinence according to his semen analysis results.
Preparing for your egg retrieval
Food and liquidsYou need to abstain from food and liquids starting at 21:00 (9:00 pm) on the previous night.
Prepare your intimate zone by removing the hair around your genitals. Also, it is recommended not to use body lotions, strong perfumes, and have nail polish.
We recommend you come to the hospital at least 15 minutes before your appointment so that any administrative procedures can be finalised if needed.
At the Registration Desk, you will receive all necessary guidance on where to wait and when will your partner be called to the Andrology lab.
Egg retrievals are performed in three dedicated specialised suites on Floor 1 of Nadezhda hospital, immediately next to the Embryology lab.
Before you are taken up to the waiting room, where you will wait for your turn with the other patients, you will leave your personal belongings and clothes (including shoes and underwear) in a private locker.
In the retrieval suite, you will be wearing single-use disposable shoes, a gown, and a bonnet. You don’t need to bring anything from home with you.
NB! Kindly note that your bladder must be empty before the procedure.
The waiting room has a bathroom for your convenience.
During egg retrieval
The team that will be with you during the procedure includes:
- The gynaecologist who will do the follicle aspiration;
- An anesthesiologist who will apply the short-term sedation and will monitor your vital signs;
- A midwife and an anaesthetic nurse;
- An embryologist.
Before the procedure, an intravenous catheter will be placed in your arm or hand (a single-use plastic cannula used to connect to a peripheral blood vessel to administer the anaesthesia or other medication as needed). Your vagina will be disinfected.
The egg retrieval is performed under short sedation for about 10 to 15 minutes.
You will feel no pain. In some cases, when only one or two follicles have to be aspirated (e.g. in natural cycle IVF), egg retrieval can be done without anaesthesia, but this is up to your wish and your doctor’s discretion.
In the embryology box adjacent to the retrieval room, the embryologist will be waiting to receive the test tubes with the aspirated follicular fluid. They will confirm the presence or absence of oocytes and handle them further.
After the egg retrieval
You will stay under monitoring at the hospital for a couple of hours after the procedure. You may have light spotting or feel bloating and cramping similar to those during menstruation.
By the time the anaesthesia wears off, the embryology lab will have informed your fertility consultant about the number of eggs retrieved and if they are good to fertilise. According to this, your doctor will give you detailed further guidance on the medication you need to take by the time of embryo transfer.
We recommend that you take the day off work and abstain from driving following the egg retrieval. Before leaving the hospital, remember to visit the Registration desk to give your details for issuing a sick leave certificate. Your sick leave starts on the day of egg retrieval.
In the period between egg retrieval and embryo transfer, you will have regular contact with the embryologists who will inform you about the development of your embryos.
Adverse events
Egg retrieval is a minimally invasive manipulation that nevertheless has its risks. They are described in the informed consent declaration that you have to read carefully before the procedure.
If following egg retrieval you have any of the following symptoms, you have to visit the hospital urgently:
- Severe pain;
- Heavy bleeding;
- Vomiting;
- Vertigo (lightheadedness) or fainting.
Don’t hesitate to contact us promptly if you develop any symptoms that concern you.
What does your partner have to do?
Once the egg retrieval is finished and the Embryology lab confirms the presence of oocytes in the aspirated follicular fluid, your partner will be called to produce ejaculate so his sperm can be processed and prepared for fertilisation.
Semen is collected into a sterile container by masturbation in a dedicated collection room neighbouring the Andrology lab.
The following has to be observed before semen collection:
- Empty bladder;
- Mandatory washing of hands and genitals;
The container is handed over for processing to a biologist from the Andrology lab, where the spermatozoa are prepared for their primary role by washing, capacitation and hyperstimulation.
In IVF, eggs can be fertilised using sperm from the partner (either fresh, provided on the day of retrieval, or frozen) or donor sperm. The wish to use donor sperm should be declared in writing before starting the IVF cycle, with the couple signing all necessary documents.
In cases of azoospermia (the complete absence of spermatozoa in the ejaculate), sperm can be retrieved by TESE, a surgical extraction procedure, if recommended by a consultant andrologist. Your partner will be informed in detail about this option before the manipulation.
If frozen or donor sperm will be used for fertilisation, or if egg freezing is planned and not embryo freezing, your partner does not have to come with you to the hospital.
Please be advised that if the use of frozen sperm is planned, your partner has to request the thawing and use of his cryopreserved genetic material. So, if he will not be accompanying you on the day of egg retrieval, you will need to have his notary-signed power of attorney. Sample power of attorney can be received at the Andrology lab.
See also
Preparing for IVF
Stimulation
