Ultrasound Guided Egg Retrieval

In Vitro Fertilization Program

When blood hormones reach the desired levels and ultrasound shows ovarian follicles to be the desired size and number, hCG hormone is given and egg retrieval is scheduled 36 hours later.

Pre-Operatively (two to three days prior to egg retrieval)

1. Preoperative instruction booklets will be provided and reviewed with you by the IVF nursing staff.
2. The physician will review your history and obtain your informed consent for the procedure.
3. Fresh semen collection is scheduled at the time of egg retrieval.  If needed, the sample frozen for back up can be thawed and used to inseminate the eggs.

During The Procedure

With the help of ultrasound images, a needle is passed through the back of the vagina and into ovarian follicles.  The eggs are drawn out of the follicles with gentle suction.  Usually intravenous (IV) medication is used for sedation and to maintain comfort.  Spinal anesthesia is another option for keeping you comfortable during retrieval.

As fluid is obtained from the follicles, an IVF nurse transports all of the fluid that is withdrawn from the follicle to the In Vitro Fertilization Laboratory.  An embryologist examines the fluid for eggs under a microscope.  When an egg is located, it is picked up in a very small quantity of fluid, washed, and placed in the incubator.  Oocytes are typically recovered from 75 percent of the follicles over the size of 10 mm.  Approximately 80 percent of the oocytes will have completed maturation by the time the laboratory performs the insemination.  The following example is based on our program’s average oocyte recovery, maturity and fertilization rate.  Oocyte recovery, maturity and fertilization rates will vary patient-to-patient and cycle-to-cycle.  The following is only an example.

Example:                                     

16 follicles >10 mm                X            75% recovered           =     12 oocytes

12 oocytes recovered               X            80% mature                =     10 mature oocytes

10 mature oocytes                   X            70% fertilize               =     7 embryos

The Mature Oocyte.  The oocyte has two surfaces that must be penetrated by the sperm.  The first is the zona pellucida.  The zona pellucida protects the oocyte and prevents excess sperm from entering the oocyte after one sperm has penetrated the oocyte.  The plasma membrane is the second surface that the sperm must cross.  The polar body represents extra genetic material that the oocyte sheds prior to fertilization.  Presence of a polar body is an indication of oocyte maturity.  A second polar body is shed after fertilization has occurred.

1. You will be given information about the number, maturity and quality of eggs obtained following retrieval.
2. Recovery:  After a period of close observation, the woman is ready to leave the recovery area with her partner’s assistance.  Recovery time for ultrasound guided oocyte retrieval is generally one to two hours.