Egg retrieval, hour by hour: what really happens

The day before an egg retrieval, the messages I receive are all similar: ‘Will I feel anything?’, ‘Will I be able to walk?’, ‘What if I miss the injection time?’. Here, in order, is what happens — and what depends on you.

36 hours beforehand: the trigger injection

Once the follicles have reached the correct size on the ultrasound scan, the doctor sets the time for the trigger injection (hCG, GnRH agonist, or both). The egg retrieval is scheduled for approximately 34 to 36 hours later. This timeframe is precise: if it’s too early, the eggs won’t be mature; if it’s too late, ovulation may have already occurred.

My advice, which I always give: set two alarms, write the time down, and send a photo of the empty syringe to the clinic or your coordinator. If you’re in a different time zone, the time that counts is that of the country where the egg retrieval is taking place.

On the morning itself

• On an empty stomach: generally, no food or drink for six hours beforehand (the clinic will give you its exact instructions).
• No make-up, nail varnish or jewellery, hair tied back, loose-fitting clothing.
• A companion: after sedation, you must not drive or go home alone. In Greece, the journey is often made by taxi; a relative or someone you trust must be present.
• Your partner, if you have one, will usually provide a semen sample on the same morning.

The procedure

The aspiration is performed vaginally, under ultrasound guidance. A fine needle guided by the probe passes through the vaginal wall and aspirates the fluid from each follicle; the embryologist then searches for the eggs under the microscope in real time. There are no incisions or stitches.

In Greece, the aspiration is almost always carried out under intravenous sedation by an anaesthetist: you are in a light sleep and feel nothing. The procedure itself lasts 15 to 30 minutes, depending on the number of follicles. You are then kept in the recovery room for one to two hours.

Afterwards: what to expect

• Period-like cramps and a bloated stomach for one to three days.
• Light vaginal bleeding, caused by the needle puncture.
• Fatigue on the day of the procedure, due to the sedation.

Paracetamol is usually sufficient. Avoid anti-inflammatory drugs without medical advice. Rest on the day of the procedure; gentle walking is possible from the following day.

When to contact the clinic

• Abdominal pain that gets worse rather than better, or a fever.
• Heavy bleeding, feeling unwell, or dizziness when standing up.
• Rapid swelling of the abdomen, weight gain of more than one kilo per day, shortness of breath, or low urine output: these are possible signs of ovarian hyperstimulation.

Serious complications (haemorrhage, infection) occur in fewer than one in a hundred cases. They are rare, but that is precisely why you need to know who to call, at any time, during your stay.

The results: how many eggs?

You will find out on the same day how many eggs have been retrieved. This figure is not the number of embryos: not all eggs are mature, not all are fertilised, and not all embryos reach the blastocyst stage. This attrition is normal and to be expected. The following day, the laboratory will inform you how many eggs have been fertilised.

Travelling after an egg retrieval

If a fresh transfer is planned, it takes place three to five days later; you will therefore need to stay where you are. With a ‘freeze-all’ strategy or when eggs are frozen, it is generally possible to fly 24 to 48 hours after egg retrieval if you are feeling well and no signs of hyperstimulation have appeared — but this must be approved by your doctor. I discuss this in more detail in the article on flying whilst undergoing IVF and in the one on the length of your stay.

Frequently asked questions