You should have nothing to eat or drink in the eight hours prior to your retrieval. This procedure begins in the same fashion as a vaginal ultrasound. You will receive small doses of medication given intravenously, which will make you relaxed and sleepy.
Recovery from these drugs, for most patients, is rapid and generally nausea is minimal. Your vagina will be cleaned to minimize the risk of infection. The vaginal transducer is inserted into your vagina, and the eggs are retrieved with a needle inserted through the vaginal wall under the guidance of ultrasound. No abdominal incisions are required.
Report to GRS at your assigned time. DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT. When you arrive, tell the clerk that you are an IVF retrieval patient and let her know what time you are posted for surgery. Please make sure to arrive without jewelry, nail polish, make-up, or contact lenses. You may wear your wedding rings.
Shortly before your retrieval, an attendant will escort you to the preparation area. Please note that usually no preoperative sedatives are administered. While you are in the preparation area, please try to empty your bladder completely. If an epidural anesthesia is planned, the anesthesiologist will confer with you and answer any questions you may have regarding your anesthesia. When all is ready, you will be taken into the procedure room and asked to lie on the procedure table. If you do not yet have an intravenous line, one will be started. Next, you will receive medication to make you feel relaxed and drowsy, or you will receive medication to put you to sleep (as discussed earlier under anesthesia). The procedure will last about 25 to 45 minutes.
Your partner will be asked to provide a semen specimen before or immediately after the time of your retrieval. Following your initial recovery your partner may be with you. The time you will be required to remain for observation will vary between patients. IVF retrieval patients will generally stay approximately 60 minutes while patients who have had an epidural block will remain for approximately two or three hours. When the nurse feels that your condition is stable, you will be discharged. Patients are not allowed to drive themselves home after retrievals. Following your retrieval, you may eat or drink when you feel well enough. At this point, following your procedure, you should begin taking your antibiotic if you have not been instructed to start them earlier.
Sometimes when immature eggs are retrieved, male factor fertility is present, or if fertilization does not occur, your husband may be required to provide a second semen sample. This generally will occur the day after retrieval, but may occur later the same day. Arrangements will be made to contact him the morning following retrieval if this is necessary.
Following transvaginal ultrasound retrieval you may experience some pelvic area tenderness and feel tired or sleepy from the medications you have received during the procedure. You will also have some light vaginal spotting. This bleeding should be scant and may be red to brown in color.
The medications used during your egg collection may not be eliminated by your body for up to 24 hours. You may feel "hung over" or just not your normal self. During this period we ask that you do not:
You may eat whatever you like after the egg collection, as long as you are not nauseated. If you experience nausea, stick to clear liquids and crackers until the nausea subsides. It is usually best to avoid spicy foods for at least 24 hours.
- Drive a car or operate machinery or power tools.
- Drink any alcoholic beverages.
- Make any important decisions.
Antibiotic therapy (tetracycline) is administered to minimize the risk of infection following this procedure. An antibiotic is usually given four times daily immediately after your retrieval for a total of seven days.
Medrol, a steroid hormone, is given daily for a period of four days to assist pre-embryo implantation. This is given orally once a day for a total of four days to assist pre-embryo implantation.
Progesterone is a hormone produced by the remains of the ruptured follicle (corpus luteum). Progesterone helps the lining of the uterus become thick and is therefore essential for the implantation of the pre-embryo. As estrogen levels are higher in stimulated ovarian cycles, it is necessary to administer natural progesterone supplements to establish a normal estrogen/progesterone ratio. Therefore, hCG or additional progesterone supplements may improve the uterine lining and enhance the possibility of pre-embryo implantation. You will be instructed by the IVF nurse on the exact route and administration of natural progesterone supplementation assigned to your physician. The progesterone can be administered through a vaginal gel, tablet, suppository or an IM injection. The FDA has released a warning about the use of synthetic progesterone during pregnancy; however, the natural progesterone supplements used in conjunction with an IVF cycle are recognized as safe.
You will be contacted by the nurse on the day following your egg retrieval and given the status report on your eggs and sperm. At this time, fertilization will be seen in most cases, but embryo replacement can only be confirmed when the fertilized egg divides normally, usually after one additional day. As you know, although rare, one of the risks of IVF is lack of fertilization. Sometimes the reason for this is understood but many times no reasons are apparent. If this occurs, monitoring will be discontinued. You will be given an opportunity to meet with your physician and or the embryologist regarding the implications of this finding. Having intercourse between retrieval and transfer is suggested and may improve implantation.
You should abstain from sexual intercourse for two weeks after the embryo transfer. Your physician may advise sexual intercourse after egg retrieval. You should also abstain from strenuous physical activity during those two weeks. If you have any questions about a particular activity, please contact your physician.
Please contact your doctor if any of the following occur:
- Fever greater than 100.4°F that lasts for more than two hours
- Excessive vaginal bleeding
- Unusual and increasing pelvic area discomfort
- Difficulty with urination or change in bowel activity
- Nausea, vomiting or diarrhea
- Sharp or shooting pains
- Pain or burning during urination
- Abdominal swelling
- Unusual back pain