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IVF procedure

Details the egg collection stage of IVF treatment.


Egg collection

This is usually performed in the morning or early afternoon, approximately 36 hours after the hCG injection. Some clinics allow the male partner to attend the egg collection procedure if their wives have the operation under sedation. A monitor connected to the microscope will allow you to view the eggs when collected.

Methods of egg collection

Several methods can be employed to collect the eggs, these include:

Vaginal ultrasound guided egg collection

This is the most commonly used technique; it is a minor and safe surgical procedure usually performed under conscious sedation because it is a safe and acceptable or a general anesthetic. Sedation is a safe and ecceptable method of providing pain relief for egg collection.

A vaginal ultrasound probe with a fine hollow needle attached to it, is inserted into the vagina. Under ultrasound guidance, the needle is then advanced from the vaginal wall into the ovary to suck out the fluid from the follicle. The fluid is then examined under the microscope to identify the egg. Each egg is removed in turn through the needle by a suction device. Follicle flushing is not associated with improvement in pregnancy rates or the number of eggs collected, but does increase the duration of the procedure and associated pains. The whole procedure takes about 20-30 minutes.

You may experience some mild discomfort following the procedure, but this will be relieved with painkillers. Antibiotic is usually given to prevent infection.

Transvaginal egg collection is associated with a common risk of minor vaginal bleeding, which varies between 0.5% and 8%, occasionally severe abdominal bleeding, the incidence of which varies between 0.02% and 0.7%. other complications include the risk of pelvic infection which varies between 0.4% and 1.3% and the risk of accidental damage to pelvic organs.

Vaginal ultrsound egg collection.

Abdominal ultrasound guided egg collection

Occasionally, egg collection is performed by passing a needle through the abdominal wall into the ovaries under ultrasound guidance. This is usually performed if the ovaries are abnormally placed.

Laparoscopy

Originally, eggs were always collected laparoscopically. This method of egg collection is hardly ever used nowadays, as it requires a general anesthetic, in addition to the risks of laparoscopy.

It is difficult to predict the number of eggs from the ultrasound scan, the doctor may collect either more or fewer eggs than had been anticipated. However, the average number of eggs collected is about 12 depending upon the number of follicles present. Not every follicle contains an egg. Occasionally, no eggs are collected, so-called “empty follicle syndrome”. The reported incidence is about 1%.  Sometimes, giving another dose of hCG and scheduling another egg collection 24 hours later could salvage the cycle. The cause of empty follicle syndrome is unknown, but it is possible that it is a drug related rather than a clinical problem.

What happens after egg collection?

Pain

The patient may experience pain. It is not unusual for women to experience some abdominal or pelvic pain. A hot water bottle or painkillers are often helpful. However, if the pain is severe, or persists, then you should consult your doctor.

Bleeding

The patients may have to wear panty liners for a day or two following egg collection. Any bleeding should be minimal and dark or brown in colour. If bleeding is severe or bright red then consult your doctor.

Nausea and vomiting

The patient may experience nausea or vomiting for the first 24 hours following egg collection. This is usually a side-effect of the drugs given (anaesthetics or pain killers). If the nausea or vomiting persists, the you should consult your doctor.

Activities

You are advised to rest during the first 24 hours following surgery and must not operate any machinery such as a car or cooker. Furthermore, a responsible adult must be available to look after you during this period.

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