A guide and in depth look at IVF: Egg Retrieval by Laura Sirkovsky-Kauffman

Step 1, Egg Retrieval
When you begin the journey of expanding your family, you never necessarily think it will end up here. Some women have advance warning (if you suffer from PCOS or endometriosis) you are often told that you may require assistance with your fertility journey. However, for those who have no pre-existing conditions, you seldom think it will come to this.

In vitro fertilization, otherwise known as IVF, is a daunting task for many people. It puts strains on you physically, emotionally, financially, and sometimes spiritually. Before we get into the depths of this conversation, we need to look at step one, which is the egg retrieval and follicle stimulation process.

Follicles are what live inside your ovaries and will eventually become eggs. Typically, every month, a woman will have a certain number of follicles in each ovary when it leads up to her ovulation period. One of the follicles will end up being “stronger” than the others and grow to be the biggest. It will then become an egg and be released into the fallopian tube. The hope (for those trying to conceive) is that the egg will be fertilized during the 5 day journey it takes for the egg to travel from the ovary to the uterus. The fertilized egg will then embed itself into the wall of the uterus, attach, and a pregnancy will commence. IVF begins with follicle stimulation.

If you have heard someone discuss IVF, then you may have heard them use the term “rounds”. Don’t be alarmed, it is not a boxing match. It is referring to the number of times a woman will undergo follicle stimulation. When beginning IVF, you will meet with your doctor and they will decide on what protocol they feel is best for you to produce a safe number of eggs for them to extract from your ovaries. This process is known as the egg retrieval. The goal is to stimulate enough follicles to become eggs of the appropriate size (18mm-25mm each), so that they can be fertilized outside of the body (isn’t science wild!)

Follicle stimulation will involve multiple injections at the same time every time and you will then go in to your clinic to have ultrasounds multiple times throughout these 9-12 days to see how your follicles are progressing. If it looks like your follicles are growing too quickly (as mine were) your doctor may lower your dosage to make sure it slows down and it gives the smaller follicles a chance to catch up. If your follicles aren’t growing at a rapid enough rate, they may up your dosage, or add a new medication mid-cycle.  Follicles do not all grow at the same rate. It can be tricky to get everything to be steady, but your doctors know what they are doing. 

When your doctor feels that your follicles have reached the optimal size (and you have a good number of follicles) they will tell you to stop your medication and take a trigger shot. This will “trick” your body into thinking it is ovulating and help with the removal process of the eggs. You will have your egg retrieval within 72 hours of the trigger shot, and be told to take antibiotics the night before the surgery (be forewarned, they will likely make you very nauseated as they are a high dose). As with most procedures, they will medically clear you, tell you how late you should stop eating the night before, and give you all of the information you need prior to the surgery.

Retrieval Day
You will go in, talk with a few nurses / doctors, and meet with an anaesthetist who will go over the cocktail they will give you. You will most likely be given a light sedation which will last no longer than 30 minutes. The procedure itself involves inserting a needle through the vagina up to the ovaries. The needle will then pierce the ovary, and remove one egg at a time. I myself had 29 eggs and the procedure was around 25 minutes. Once the procedure is over, you will be brought back to a bed, left to rest up for a while, and when you wake up, be given a snack! You should be told when you wake up how many eggs they were able to retrieve, however, you will not know until the next day as to how many were the “right size” that can be used for IVF. 

Physically, the egg retrieval process is the most difficult part. There are a few things left to consider and contemplate if you are about to go through this process. 

If you are older, some women consider doing 2 retrieval cycles back to back. I myself did not do this but if it is something you are interested in pursuing, speak to your doctor about it! Lastly, the most major risk for an egg retrieval surgery and follicle stimulation is something called hyper ovarian stimulation syndrome aka HOSS. This can happen when a woman produces too many eggs and during the retrieval process, the liquid that surrounds each egg leaks into the body. If you tend to produce a higher number of follicles each month, you are at higher risk for HOSS, however, it is not overly common and your doctor will be able to answer any and all questions regarding HOSS.

Now that the eggs have been removed from the body, they will be paired with sperm and you hope that they will begin to form embryos! The most difficult part (physically) is now over and more of a mental challenge begins. If you have questions about freezing your eggs, and or egg retrievals, be sure to speak to your doctor. 

Laura Sirkovsky-Kauffman is currently pregnant from a frozen embryo transfer after undergoing IVF. She loves to talk to others about their experiences with getting pregnant and pregnancy. You can find her at @siftrva on Instagram or at www.siftrva.com.