Egg retrieval is the pivotal moment of your IVF cycle — the culmination of weeks of injections, monitoring, and anticipation. It's normal to feel nervous, especially if you've never had any kind of surgical procedure before. But understanding exactly what happens can help ease those worries.
This guide walks you through everything: the final days of preparation, what happens in the procedure room, anesthesia options, recovery expectations, and what happens next in the embryology lab.
The Days Leading Up to Retrieval
Monitoring and Trigger Timing
In the days before retrieval, you'll have frequent monitoring appointments — often daily — to track follicle growth via ultrasound and estradiol levels via blood tests. When your leading follicles reach 18-22mm and hormone levels indicate readiness, your doctor will "trigger" you.
The Trigger Shot: Precision Timing
The trigger shot (Ovidrel, Lupron, or dual trigger) causes final egg maturation. You'll be given a very specific time — often down to the minute — to administer it. Retrieval is scheduled exactly 34-36 hours later.
Example: Trigger at 9:00 PM Monday → Retrieval at 8:00 AM Wednesday
This timing is critical. The trigger starts a countdown to ovulation. If retrieval happens too late, eggs may be released and lost. Too early, and eggs won't be mature enough.
⚠️ Do Not Miss or Mistime Your Trigger
Set multiple alarms. Write it down. Tell your partner. Have a backup plan. If you're traveling, triple-check time zones. A missed or mistimed trigger can cancel your entire cycle.
If you accidentally miss your trigger window, call your clinic immediately — they may be able to adjust the retrieval time.
Final Pre-Retrieval Instructions
Your clinic will provide specific instructions, which typically include:
- Fasting: Nothing to eat or drink after midnight (usually 8-12 hours before procedure)
- No perfumes or scented products: Strong fragrances can be toxic to eggs
- Comfortable clothing: Loose, easy to change
- No jewelry or nail polish: Monitors need access; some facilities require removal
- Arrange transportation: You cannot drive yourself home after sedation
- Take day off work: Plan to rest the rest of the day
Retrieval Day: What to Expect
Arrival and Check-In
You'll typically arrive 30-60 minutes before your scheduled procedure time. The process usually goes:
Check-In & Paperwork
Sign consent forms, confirm identity, review procedure. You'll change into a hospital gown and remove jewelry, contacts, and any hair accessories.
Pre-Procedure Preparation
Nurse takes vitals, confirms fasting, starts IV line for sedation. You may be given antibiotics and sometimes a mild sedative.
Move to Procedure Room
Walk or wheelchair to operating room. Meet the anesthesiologist and confirm your identity one more time (standard safety protocol).
Anesthesia Options
Most egg retrievals are performed under "conscious sedation" or "twilight sedation" — you're not fully unconscious but deeply relaxed and typically don't remember the procedure.
Common Anesthesia Approaches
- IV Sedation (most common): Medications like Propofol and Fentanyl through IV. You breathe on your own but are heavily sedated. Most women remember nothing.
- General anesthesia: Fully unconscious with breathing tube. Less common for egg retrieval but used in some cases.
- Local anesthesia only: Rare; numbing injection to cervix. You'd be awake and feel pressure but not pain. Sometimes used in mini-IVF or low egg count situations.
Talk to your anesthesiologist beforehand if you have concerns, previous reactions, or preferences. Most women are pleasantly surprised by how manageable the experience is.
The Procedure Itself
Here's what happens while you're sedated:
- Positioning: You're placed in a position similar to a pelvic exam, with legs in stirrups.
- Ultrasound guidance: A transvaginal ultrasound probe is inserted to visualize your ovaries.
- Needle insertion: A thin needle attached to the ultrasound probe is passed through the vaginal wall into each follicle.
- Aspiration: Gentle suction draws out the fluid from each follicle. Each follicle takes 30-60 seconds.
- Egg identification: The embryology lab immediately examines each fluid sample to identify and count eggs.
- Repeat: The process continues until all accessible follicles are drained on both ovaries.
The entire procedure typically takes 15-30 minutes, depending on the number of follicles.
💭 What You Might Experience
Most women remember almost nothing. If you do have awareness, you might feel some pressure or mild cramping. The sedation keeps you calm and comfortable. Many women describe waking up surprised it's already over.
While You're in Procedure...
Your partner (if providing sperm that day) will be directed to a collection room to produce a semen sample. This happens during or shortly after your retrieval so fresh sperm is ready when your eggs arrive in the lab.
How Many Eggs to Expect
The number of eggs retrieved varies widely based on age, ovarian reserve, and response to stimulation.
| Ovarian Reserve | Typical Egg Count |
|---|---|
| Low reserve (low AMH/AFC) | 1-5 eggs |
| Normal reserve | 8-15 eggs |
| High reserve/PCOS | 15-30+ eggs |
The Attrition Funnel
Not every follicle contains a mature egg, and not every egg will become a viable embryo. Here's the typical attrition:
The Numbers Journey
Example starting with 12 follicles:
- 12 follicles seen on ultrasound
- 10 eggs retrieved (some follicles empty)
- 8 mature eggs (MII)
- 6 fertilized normally
- 4 reach blastocyst (Day 5)
- 2-3 chromosomally normal (if PGT-A tested)
This attrition is normal and expected. You don't need dozens of eggs — you need enough to give you good embryos to work with.
Recovery: The First Hours
After the procedure, you'll be moved to a recovery area where nurses monitor you as the sedation wears off.
Recovery Room
You'll wake up gradually, possibly feeling groggy or emotional (both normal). Nurses monitor vitals and watch for complications. You may feel crampy, like period cramps.
Initial Recovery
Once awake enough, you can drink water and have a light snack (crackers, juice). The doctor or embryologist may share initial egg count.
Discharge
Once stable and able to walk with assistance, you're discharged to go home. You MUST have someone drive you — you cannot drive, take public transit alone, or make major decisions for 24 hours.
Common Post-Retrieval Symptoms
- Cramping: Like period cramps, ranging from mild to moderate. Usually peaks day of and day after.
- Bloating: Your ovaries are still enlarged. This may actually worsen slightly before improving.
- Spotting: Light vaginal bleeding is normal from the needle puncture sites.
- Fatigue: Both from sedation and the physical stress of the procedure.
- Emotional volatility: Hormone changes plus the intensity of the moment. Tears are common.
- Constipation: From sedation and pain medications. Stay hydrated.
💡 Recovery Tips
- Rest: Take the day off. No major activities.
- Heat: Heating pad on low for cramps (not directly on skin)
- Hydration: Drink plenty of water and electrolytes
- Comfortable clothes: Nothing tight on your abdomen
- Pain relief: Tylenol is usually safe; confirm with your clinic before taking anything
- Gentle movement: Short walks are fine and may help with bloating
What to Avoid After Retrieval
- Driving: Not for 24 hours after sedation
- Heavy lifting: Nothing over 10 lbs for several days
- Vigorous exercise: Your ovaries are still enlarged; risk of torsion
- Swimming/baths: No submerging for 48-72 hours (shower is fine)
- Sex: Usually advised to wait until after transfer or period
- Alcohol: Avoid for 24 hours due to sedation
- NSAIDs: No ibuprofen (Advil), naproxen (Aleve) unless approved — may interfere with implantation if doing fresh transfer
Warning Signs: When to Call Your Clinic
⚠️ Contact Your Clinic Immediately If You Experience:
- Severe abdominal pain not relieved by Tylenol
- Heavy vaginal bleeding (soaking a pad in an hour)
- Fever over 101°F (38.3°C)
- Difficulty urinating or very dark urine despite drinking
- Rapid weight gain (3+ lbs in 24 hours) — sign of OHSS
- Severe bloating, distension, or abdominal tightness
- Nausea/vomiting that prevents you from keeping fluids down
- Dizziness or fainting
- Shortness of breath
These could indicate ovarian hyperstimulation syndrome (OHSS), infection, or internal bleeding. Early intervention is important.
What Happens in the Lab
While you're recovering, your eggs begin their next journey in the embryology lab.
Day 0: Retrieval Day
- Eggs identified and counted
- Maturity assessed (MII = mature, MI or GV = immature)
- Sperm prepared (if using fresh sample)
- Fertilization: Either conventional IVF (eggs + sperm in dish) or ICSI (single sperm injected)
Day 1: Fertilization Check
- Embryologists check for signs of normal fertilization
- Normal fertilization shows 2 pronuclei (2PN) — one from egg, one from sperm
- You'll receive your "fertilization report" — how many fertilized normally
Days 2-3: Early Development
- Embryos divide: 2-cell, 4-cell, 8-cell
- Some embryos may arrest (stop developing)
- Day 3 embryos have 6-10 cells
Days 5-6: Blastocyst Stage
- Remaining embryos reach blastocyst (100+ cells)
- Grading assigned (e.g., 4AA, 5BB)
- Decision: Fresh transfer, freeze all, or PGT-A biopsy
The attrition from fertilization to blastocyst is normal — typically 30-50% of fertilized eggs reach blastocyst. Quality matters more than quantity at this stage.
Getting Your Results
Clinics vary in how and when they communicate results. Typical timeline:
| Timing | Information You'll Receive |
|---|---|
| Day 0 (retrieval day) | Number of eggs retrieved |
| Day 1 | Fertilization report (how many fertilized normally) |
| Day 3 (sometimes) | Development update |
| Day 5-6 | Final embryo count and grades |
| Day 12-14 (if PGT-A) | Genetic testing results |
The wait for results can be anxiety-provoking. Try to stay distracted. Remember that embryo development is out of your control at this point — worrying won't change the outcome.
Physical Recovery Timeline
Worst of It
Most cramping and bloating peaks. Take it easy. Rest, hydrate, gentle movement.
Improving
Symptoms should be improving. Some bloating may persist. Light activities okay.
Near Normal
Most women feel back to normal. Period usually comes 10-14 days after retrieval if no transfer.
Fully Resolved
Ovaries return to normal size. Any residual symptoms resolve.
Emotional Considerations
Egg retrieval is emotionally intense — you've built up to this moment, and now you're waiting to find out if it worked. Common feelings include:
- Relief: The hardest physical part is over
- Anxiety: Waiting for fertilization and development reports
- Hormone crash: Estrogen drops dramatically after retrieval, which can affect mood
- Hope and fear: Simultaneously wanting good news and bracing for disappointment
- Guilt: If numbers are lower than expected (remember: not your fault)
Be gentle with yourself during this time. Lean on your support system. Distraction can help.
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Get Free ConsultationChecklist: Preparing for Retrieval Day
📋 Before Retrieval
- ☐ Confirm trigger shot time and retrieval appointment
- ☐ Arrange ride home (you CANNOT drive yourself)
- ☐ Take day off work
- ☐ Prepare comfortable recovery area at home
- ☐ Stock up on easy foods, electrolyte drinks, heating pad
- ☐ Set multiple alarms for trigger shot
📋 What to Bring
- ☐ ID and insurance card
- ☐ Comfortable, loose clothing
- ☐ Socks (procedure rooms are cold)
- ☐ Phone and charger
- ☐ Book or entertainment for waiting
- ☐ Snacks for after (crackers, etc.)
- ☐ Prescription for progesterone (if starting that day)
📋 Leave at Home
- ☐ Jewelry and valuables
- ☐ Contact lenses (wear glasses)
- ☐ Perfume, scented lotion, strong-smelling products
- ☐ Nail polish (some clinics require removal)
The Bottom Line
Egg retrieval is a brief but significant procedure. With modern sedation, most women find it far more manageable than expected. The physical recovery is typically quick — a few days of cramping and bloating, then back to normal.
The emotional journey continues as you wait for news from the lab. Remember: you've done everything you can. The development of your embryos is now in the hands of nature and your embryology team.
Trust the process, take care of yourself, and know that whatever happens, you're one step closer to answers — and hopefully, to your baby.
Read more: Understanding Embryo Grading | Fresh vs Frozen Transfer | Surviving the Two-Week Wait