Egg Retrieval
Collection of eggs is usually performed under transvaginal
ultrasound guidance. The follicular fluid is drawn up into a test tube to obtain the
eggs. Although patients are given medications for pain, some women experience some
discomfort during the procedure.
Time taken: 30-45 minutes.
Hospitalization: None, usually discharged within a couple of hours after the retrieval.
Collecting and preparing the sperm
A semen sample is obtained from the male partner, usually while the retrieval is being
performed. It is recommended to observe 2-4 days of abstinence prior to providing the
semen. The sperm from the specimen is prepared for inseminating the eggs collected. A
second sample of fresh semen may be needed 1-2 days after egg retrieval to inseminate
egg(s) that were not mature or did not initially fertilize.
Insemination of eggs and embryos
culture
Following egg retrieval, the follicular fluid is immediately analyzed for identification
and evaluation of eggs and readied for insemination. While collecting the fluid, several
eggs are usually obtained. All of these eggs are inseminated to maximize the number of
embryos available for subsequent transfer. The prepared sperm is then added to each egg
and allowed to incubate overnight under controlled laboratory conditions. Next day, each
egg is evaluated for evidence of fertilization. However, it is possible that no eggs
fertilize.
The eggs that have fertilized will be allowed to develop for one or more additional days
under controlled laboratory conditions before they are placed inside the woman's uterus.
Depending upon the couple's wishes, in some centres, some fertilized eggs or embryos may
be frozen and stored for future use.
After the embryos are transferred to the womb, progesterone supplementation that was
started after the egg retrieval procedure is continued. Progesterone has been shown to
create a more favorable environment for the embryos, therefore increasing pregnancy rates.
Transferring embryos to the uterus
Embryos are transferred to the uterus through a small tube, or catheter. This procedure is
usually painless. The embryos are placed in a small amount of fluid inside the catheter
and are placed in a manner so they reach the top part of the uterus. The number of embryos
transferred depends on individual circumstance; two to four embryos may be transferred in
one treatment cycle.
Embryo transfer can cause mild cramping. Even though rare, the embryo(s) may be displaced
through the cervix (causing loss of embryos) or into the fallopian tubes (causing possible
tubal pregnancy). A small risk of bleeding or
infection does persist.
After transfer, the woman may get dressed and leave after a brief rest. A pregnancy test is done 12-14 days after the transfer
regardless of whether the patient has had any uterine bleeding.
The transfer of several embryos increases the probability of success. Multiple embryo
transfer also increases the risk of multiple pregnancy. Approximately 20-25 % of
pregnancies with IVF will be a multiple pregnancy. Most of these will be twins. Triplets,
quadruplets or even greater multiple pregnancy can occur.
- Risks associated with Multiple Pregnancy
- All multiple pregnancies carry an increase risk of miscarriage(s), premature labor and premature birth.
- Pregnancy-induced high blood pressure and diabetes are more common in women pregnant
with more than one fetus.
- Prolonged hospitalization may be necessary for these pregnant women and for the mother
and babies after delivery.
- Tubal (ectopic) pregnancy is also
possible, and a combination of normal
pregnancy and ectopic pregnancy
may occur.
