Ovum pick-up, egg harvesting, egg collection or egg retrieval is a technique done through surgery. Follicle or ovarian puncture is the medical term used to make reference to this process. It is an easy and short procedure done under mild anesthesia or sedation. It is not painful or involves severe risks. Bed rest is not required, as recovery is simple and occurs almost immediately.
It consists in inserting a needle through the ovarian follicles to aspirate the follicular fluid where the oocytes are located.
The various sections of this article are assembled in the following table of contents.
Control of the menstrual cycle
Oocytes develop in the ovary inside structures called follicles. As follicles increase their size and get filled with follicular fluid, a human oocyte matures.
A set of follicles grows and develops each month to allow for the maturation of the eggs they contain. However, only one of them will be capable of making it to the final stage.
Around halfway through the menstrual cycle, the most developed follicle bursts and releases an egg with it. This is what we know as ovulation.
Women who become egg donors are administered hormone medications in order for their menstrual cycle to be slightly altered, thereby stimulating egg production. It allows for all follicles (or nearly all) to continue with the maturation process till the final stage, so that multiple mature eggs are finally obtained.
Before ovulation occurs naturally, donors undergo follicle puncture to harvest the mature eggs from the ovary.
As we know, ovulation is about to take place when the follicle measures 16 to 18 mm in diameter approximately. This is the reason why egg donors should have their cycle monitored on a regular basis. This way, the growth pattern of their follicles is controlled.
Once this follicle size is observed, the ovum pick-up is scheduled. Donors should administer hCG shots around 24-36 hours before that day. It is a way of making sure natural ovulation does not occur before surgery.
Egg retrieval from the ovaries
An overnight fast is required before ovum pick-up procedures. Having fasted for the previous 6 hours before surgery is crucial. Women can enter the operating room by themselves, and anesthesia will be administered once there so that they remain asleep during the procedure.
Anesthesia makes it painless and helps avoid feeling any type of discomfort. Moreover, it paves the way for the gynecologist to carry it out more properly.
Follicle puncture is a transvaginal ultrasound-guided procedure. The gynecologist inserts an ultrasound-guided fine needle through the vagina to get to the ovary.
Once there, the follicles are punctured one by one while aspirating the follicular fluid they contain, which is collected and stored in test tubes.
Ideally, the temperature of the test tubes should be 37 °C in order for the properties of the oocytes not to differ from how they were when contained in the follicular fluid.
In the laboratory, embryologists analyze the follicular fluid in the search for mature human eggs, which will be used later for the IVF cycle of the receiving woman.
The effects of anesthesia disappear after oocytes have been retrieved from both ovaries. Once conscious, donors should remain a few hours at the fertility clinic till anesthesia has worn off in full. Given that hospitalization is not needed, the donor can return home right after that.
Although being relaxed while avoiding great efforts throughout that day is essential, one can continue with her normal lifestyle from the day after onwards. The next period is expected to appear within 12-14 days after ovum pick-up, which translates into the beginning of a new menstrual cycle.
The duration of the procedure is around 20-30 minutes long, and in general there is no reason why it should cause women severe side effects beyond mild discomfort or a slight vaginal bleeding/spotting.
FAQs from users
What is the average number of eggs retrieved from donors?
Currently, the average number of eggs retrieved is 10.5 per donor. You should keep in mind that not all eggs collected may be suitable for fertilization, though.
With donor eggs, the rate of mature oocytes is high, as they are collected from young (25 years old on average) and healthy women.
Can egg retrieval be done after hysterectomy?
Yes, in principle the ovaries are intact and functional after a hysterectomy. Many women continue ovulating after having their uterus removed.
Nevertheless, if the woman was not ovulating regularly due to advanced maternal age or if she has PCOS, the quality of the eggs collected may be less viable. This could be improved with fertility drugs given to produce multiple eggs.
Is egg retrieval an option for cancer patients?
Yes, fertility preservation is a very suitable option for women who are starting cancer treatment. Radiotherapy and chemotherapy may affect a woman’s overall fertility and ovarian function, hindering her chances of becoming pregnant naturally in the future.
For this reason, undergoing egg retrieval to have your oocytes harvested and then cryopreserved is strongly advisable, as it will allow you to become pregnant in the future if you wish so.
Can egg retrieval be done without anesthesia?
Even though it is a safe technique which does not take too long, it is done under anesthesia so that it does not hurt at all. In the case of IVF patients with particular problems, follicle puncture can be done without anesthesia, yet it is not advisable.
Is bed rest necessary after follicle puncture?
Recovery is simple, as the anesthesia given is a mild one. After ovum pick-up, donors usually rest for around 3-4 hours, but after that reasonable period of time, they can come back home and continue with their routine.
Is it normal to feel abdominal pain or bloating after egg retrieval?
Ovulation induction medications and surgery for oocyte retrieval can cause donors to feel mild discomfort or pain in the abdominal area. It will disappear eventually.
What is the optimum estrogen level for egg retrieval?
The estrogen or estradiol levels should be 2000 pg/ml approximately for an average of 10 eggs retrieved, that is, around 200 per follicle.
Should I follow a special after care plan after egg retrieval?
There is no need as long as you follow your doctor’s instructions regarding medications for ovarian stimulation and the fasting time before egg retrieval. Should a particular case require special preparation, the doctor will indicate it in detail.