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Egg Retrieval Information

First you will have blood work (FSH) Follicle stimulating hormone and ultra sound (AFC) antral follicle count or resting follicle done on day 3 of your monthly cycle. These numbers will give the reproductive endocrinologist (RE) an idea of how fertile you are. Here is a chart to help explain the FSH levels:

Day 3 FSH level

  
Less than 10 Reassuring level. Expect a good response to ovarian stimulation.
10 - 12 Fair.  Response is between completely normal and somewhat reduced response varies widely). Overall, a somewhat reduced live birth rate.
12- 15 Reduced ovarian reserve. Usually show a reduced response to stimulation and some reduction in egg and embryo quality with IVF. Reduced live birth rates on the average.
15 - 20 Generally show a more marked reduction in response to stimulation and usually a further reduction in egg and embryo quality with IVF. Low live birth rates. Antral follicle count a very important consideration.
Over 20 Perhaps a "No go" level in one center. Very poor (or no) response to stimulation. "No go" levels must be individualized for the particular lab assay and IVF center. Antral follicle count a very important consideration.

 

Total number
of antral follicles

Expected response to injectable
ovarian stimulating drug
(FSH product) and chances
for success
Less than 4 Extremely low count, very poor (or no) response to stimulation and a cancelled cycle expected. Should seriously consider not attempting IVF at all.
4-7 Low count,  possible/probable poor response to the stimulation drugs. Likely to need high doses of FSH product to stimulate ovaries adequately.
8-10
Somewhat reduced count.
Slightly reduced chances for pregnancy as a group.
11-14 Normal (slightly lower) count, the response to drug stimulation can be sometimes low, but usually good. Slight increased risk for IVF cycle cancellation. Pregnancy rate not as good as the best group but still favorable.
15-26 Normal (good) antral count, should have an excellent response stimulation. Likely to respond well to low doses of stimulation product. Unlikely IVF cycle cancellation. Slight risk for ovarian over stimulation. Best pregnancy rates overall.
Over 26 High count,  Likely to have a high response to low doses of stimulation product. Higher risk for hyper stimulation (OHSS). Very good pregnancy rate.

Once these results come back, you will then start taking birth control pills to sync your monthly cycle up with the intended mom or surrogate mom’s body. Just before you finish your oral contraceptives you will more than likely be placed on Lupron or Synarel to prevent early egg release or ovulation.

The next step is the stimulation part of the cycle. This will allow your ovaries to produce more than one egg at a time. These are injections given normally in the stomach area for an average of 10-12 days. You will visit the reproductive endocrinologist regularly during this time for blood work and ultra sounds. They will continuously monitor your progress to prevent ovarian hyperstimulation syndrome (OHSS). Once your follicles are measuring between 18-20 and your estrogen (E2) is around 2400-3000 *normally* you will then be told you are going to trigger.

Triggering is where you inject Human chorionic gonadotropin (HCG) into your system to cause your body to naturally release the eggs inside the follicles. Exactly 36 hours after your trigger shot you will have your oocyte (egg) retrieval. The eggs will be ultrasound guided into each follicle in your ovaries to remove the fluid containing the egg. Most of the time, this procedure is able to be done vaginally; occasionally the Dr. has to retrieve the eggs from the stomach area, but that is extremely rare. Once the eggs are retrieved they are given separately to the embryologist to prepare each egg for insemination.
 
During the retrieval most clinics do what is known as awake sedation where you are put to sleep by (IV) sedation. The egg retrieval itself normally takes about 30-40 minutes but the reproductive endocrinologist (RE) will have you in recovery for a couple of hours sleeping off the sedation. You will need someone to drive you home from or take a taxi from this procedure. Most egg donors complain of tender belly area for a couple of days post retrieval. You need to take it easy for about 2 weeks to allow your body to recover. 
 
Some clinics require monitoring to be done at their location so if you do out of town donations you may be gone 3-10 days depending on the clinics request. However, many clinics will allow you to monitor locally until a couple of days before the egg retrieval.
 
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