Ultrasound Guided Egg Retrieval

I. Purpose

The purpose of the ultrasound guided egg retrieval is to visualize the mature follicles by transvaginal ultrasound and to enter each of them with a needle and withdraw the fluid contents of the follicle as well as the egg. This procedure is done under intravenous sedation.

II. Procedure

1. You will be brought into the procedure room (which is also used for the embryo transfer.) You will have an intravenous catheter in your hand or arm, and fluid will be continuously running (at a slow rate) into your vein. If you wear glasses, you can wear them during the procedure. Please remove your contact lenses.
    
2. You will lay down on a table, which is similar to the one used for your daily ultrasounds. A staff member will place a blood pressure cuff on your other arm, so that your blood pressure can be monitored. You will also have a pulse oximeter placed on your finger to monitor the oxygen content in your blood.
    
3. You will receive sedative medications through your intravenous line. The staff member along with the physician performing the procedure will determine the type and amount of medication necessary.
    
4. You will be asleep for the procedure and closely monitored by a staff member. Please let us know if you have ever experienced difficulty with anesthesia in previous procedures. Some women report feeling “high” or drugged after this part of the procedure; others feel sleepy.
    
5. After the drug administration, the staff person will place your legs up in special stirrups, which will support your legs. The physician will insert a speculum and clean out the inside of the vagina with a sterile salt solution.
    
6. Next your physician will insert a vaginal ultrasound probe into your vagina. He then takes a needle and passes it through the vaginal wall into your ovary (to the center of the follicle, as visualized on ultrasound), and then withdraws the fluid from each follicle.
    
7. The fluid that is aspirated from the follicle is rapidly passed to the embryologist in the adjacent laboratory, so that the egg can be located and placed in the incubator. Simultaneously, the physician will continue to aspirate the remaining follicles (withdraw fluid contents). As you will be under sedation, you should not be concerned if you do not hear the embryologist report that he or she has found an egg as each tube of fluid is passed off to them. The process of finding the eggs is often not completed until after you have left the procedure room. (You will be told how many eggs were retrieved before you leave the Center).
   
   Reminder: Not every follicle will yield an egg. Only follicles above 12mm in diameter can usually be retrieved.
    
8. Once the follicles have all been aspirated, the vaginal ultrasound probe is removed. The vagina is checked for evidence of bleeding and is cleansed. Your legs are then removed from the stirrups. The entire procedure usually takes no more than 30 minutes. You will be taken to a room for recovery. You must remain at the Center for at least a half hour following the procedure, but may remain longer if necessary.

III. Risks

• As indicated above, a needle is placed through the vaginal wall and into the ovary. Although uncommon, it is possible to tear or pierce any blood vessels or organs (including bowel) that may be in the way. Usually, these punctures are small enough that they heal themselves. However, in rare circumstances it may be necessary to repair this surgically.
   
• As in any situation where anesthesia is used, there is a risk of respiratory depression that may have an allergic reaction to the drugs used. We have access to emergency equipment and personnel that would be necessary in this situation. We do have an emergency plan in place to be used if required. These complications are very uncommon, provided you follow our instructions about remaining without food, and informing our staff of any known medication allergies.
   
• Bleeding may occur. This bleeding is usually self-limited, but in rare cases, may require surgical intervention.
   
• Infection has been reported. You are given prophylactic (“preventive”) antibiotics to help reduce this risk.