How to prepare for egg retrieval?

• Fasting: no food or drink after midnight the night before. Your clinic will tell you if you should take any of your usual medications in the morning.

• Check-in: you'll review consent forms and confirm plans for:
  • Egg freezing or fertilization
  • Use of ICSI¹, Zymot, calcium ionophore, etc.
  • Fresh transfer or embryo freezing (day 3 vs. day 5/6)
  • Source of sperm (partner fresh/frozen, donor)

• Prep: you'll change into a surgical gown, your belongings will be stored, and your partner (if applicable) may be asked to give a sperm sample.

• Final verifications, IV line and set-up: various staff members and your surgeon will come by to confirm your identity, allergies, and instructions (multiple times). You'll lie on a surgical table, legs in stirrups, and an IV will be placed in your arm.

• Sedation & Procedure: You'll be given light anesthesia (called "twilight sedation") through the IV. Once asleep, the doctor will use an ultrasound-guided needle through the vaginal wall on one side, and will then pierce each follicle, to gently suction out the fluid containing the egg. He/she will repeat the same on the other side. An embryologist collects the liquid that was aspirated from the operating room (and which contains the eggs), and processes the eggs immediately in the lab.
• Recovery: you'll wake up fairly quickly and be told how many eggs were retrieved. The staff will continue monitoring your recovery for a bit, and will then let you go get dressed back up. Most people go home 1–2 hours later with only mild discomfort.

Not usually. You will typically be put in what is colloquially called "twilight sedation". It is a moderate sedation (anesthesia): you're not fully unconscious, but you won't feel pain or remember much (if anything at all) of the procedure.

Depending on the clinics, the anesthesiologist may also add other drugs, such as anti-nausea or anti-constipation meds, to help you recover as fast and comfortably as possible.

Afterwards, and once the effect of drugs administered through IV wear off, you might feel:

• Cramping (similar to mild period cramps)
  • Some clinics will have heat pads, which you can ask for and place on your pelvic area, to help soothe the cramping. If really uncomfortable, your nurse may also give you additional pain meds through the IV.
• Mild vaginal soreness.
  • For those most attuned to your bodies, you may feel a "pinch" of pain in your vagina walls where the needle went through. This is a very dull pain however, and doesn't last very long – the perforation is tiny and closes back very quickly!
• Gas or bloating from anesthesia or constipation

Pain varies by individual but is usually manageable with heat, rest, and light pain relief.

It's normal to feel nervous, but egg retrieval is a routine procedure that fertility specialists perform daily. It's minimally invasive and has a short recovery time.

If you're especially anxious, you can ask your clinic ahead of time about options like anti-anxiety medication or extra sedation support.

• Take the rest of the day, and next day off if possible, to rest and sleep
• Your clinic's team should give you post-op instructions, and will contact you later that day or the next day, to check in on you. This is the right time to share any pain or discomfort you cannot manage well. That is also when they will share embryology updates!
• If feeling crampy or achy:
  • Use heat pads on your lower abdomen, and do take prescribed medications (pain, anti-nausea, stool softeners) as needed.
  • Report severe or unmanageable symptoms right away to your clinic.
• Avoid:
  • Baths, hot tubs, pools, sexual intercourse – or anything in the vagina (for about a week)
  • Strenuous exercise or carrying weights for a few days (light walking is okay, carrying your toddler is fine with caution)
  • Tight clothing (loose clothes help reduce abdominal pressure)
  • High-fat meals
  • Excess salt, or too little salt
  • Lying flat (elevate your legs to reduce swelling)
• Support recovery with:
  • High fluid intake: 100–120 oz (3-3.5 liters) daily
  • Electrolytes to reduce OHSS risk: with drinks like
    • Homemade oral rehydration: water + pinch of salt + lemon + a bit of sugar or honey
    • Bone broth (with sodium and protein)
    • Coconut water
    • Electrolyte powders or drinks (e.g., Liquid I.V., Nuun, Pedialyte, LMNT)
  • High protein intake to reduce OHSS risk: 80-100g/day. Best sources of protein are:
    • Lean meats and eggs, Greek yogurt, tofu
    • Bone broth or protein-fortified drinks
    • Protein shakes or powders (esp. if appetite is poor) – just be mindful of the amount sugar and salt in those
  • Fiber-rich foods to support digestion and relieve gas/constipation. Foods with mild natural laxative effects:
    • Prunes, prune juice, ripe bananas, figs, raspberries, pears, apples, kiwi, papaya, grapes, ripe banana and mango
    • Dark chocolate
    • Aloe vera juice, warm lemon water, coffee, green macha tea
    • Leafy greens, cabbage and sauerkraut, sweet potatoes, legumes
    • Chia seeds, flaxseeds, oats
    • Senna tea (very potent laxative)

Lastly, do track your symptoms and monitor your fluid intake and output (reduced urination despite good hydration could be a sign of OHSS).