What is an egg retrieval like?

Today I sucked 65 eggs. Ok, that sounds crass but it's accurate. More precisely, I retrieved eggs from four different women, which totaled 65 eggs. When women enter the procedure room to have their eggs removed/retrieved, they are always anxious. I don't blame them as most of them are experiencing this for the first time. The unknown is scary.

What is an egg retrieval like?

Disclaimer: I have never experienced an egg retrieval myself. I've had a few fertility tests, procedures, and surgeries, but an egg retrieval is not one of them. So I can't speak from experience. However, I can tell you what I've noticed having performed well over a thousand egg retrievals.

When you come to the clinic, a nurse brings you to a curtained room and starts an IV in your hand/arm. Your vitals are taken and a brief medical history is asked of you. Then you are given a anxiety tablet by mouth (ativan) and after about a half-hour, you are brought into our main procedure room. The room is very hospital-ish - appropriately so, as it's a medical procedure. There you meet the nursing procedure team, the physician, and your embryologist. You are given a morphine-like drug through your IV. The physician (one of the four of us: Taylor, Hitkari, Nakhuda or Yuzpe) puts a speculum in your vagina, washes it, and puts freezing in at the top. By now the morphine-like drip is working and you feel more relaxed. An ultrasound probe with a needle attached to it is put into your vagina and the needle is pushed through the wall of the vagina into the ovaries, one at a time. The follicles (egg sacs) in each ovary are drained. The follicle fluid looks like apple-juice, though sometimes it's red if some blood has entered the follicle when it's punctured. The fluid is given to the embryologist in the lab who slowly goes through it looking for eggs. The procedure from start to finish takes about 20 minutes and then you go back to the curtained room to recover for an hours or so, and then you go home.

In my experience, 95% of patients say it hurt much less than they feared. The other 5% say it was painful. Now if you looked at what's posted on-line, you'd think those numbers are reversed! It's not uncommon to hear someone say it hurt less than an HSG.

Why does it hurt so much less than people think? I have a few theories:

- what's posted online scares people.

- if their friends/acquaintances had pain, they are more likely to talk about it then if it was fine.

- women have so many fears about the process: what if I already ovulated? What if there are no eggs? What if something goes wrong?

Infertile women/couples have been through so much pain and sadness; their hopes and dreams ride on the success of the egg retrieval and embryo transfer. This pressure and anxiety heightens every sensation, including pain. It's amazing how often women cry, sob even, right after the egg retrieval is complete. They often can't explain why they are crying, but I think we all know that most of their emotion relates to what they have riding on this procedure.

My advice to anyone having an egg retrieval procedure: you will be ok. Tell us what you are worried about and I bet we can reassure you or make adjustments to make you more comfortable.  We all want it to be a positive experience - in every way.

Dr. Beth Taylor MD, FRCSC
Reproductive Endocrinology & Infertility