What to expect on the day of your egg collection

Oocyte pick up (OPU), Egg pick up (EPU), egg collection and oocyte collection are all terms commonly used to describe the surgical procedure during which eggs (scientifically speaking, oocytes) are removed from the female body, for the purposes of fertilising them and growing them as embryos in the laboratory or snap freezing for future use.

In the timeline of your fertility treatment, an egg collection follows the period of cycle monitoring and (usually) fertility medications to stimulate the ovaries to produce eggs.

Towards the end of your monitoring, your Genea Fertility Specialist and their team will determined the right time for your trigger injection and let you know exactly when to take it. This injection kick starts the egg maturation process (essentially getting your body ready to ovulate). Your egg collection procedure will be scheduled 34-36 hours later to collect the eggs.

For many women, the egg collection is “the big day” in their fertility treatment. Many people feel that you need a good number of mature eggs to be collected, giving you a good starting position in the numbers game of fertilisation and embryo development, and putting you on your way to (hopefully) having an embryo suitable for transfer and some in the freezer for next time.

That’s a lot of pressure!

But it’s worth noting, as much as this can be advantageous, the collection of a lower number of good quality eggs can be just as fruitful for your embryo transfer. Quality is more important than quantity.

It’s no surprise that many patients are apprehensive about their egg collection procedure. Knowing what to expect can help you cope and get through what for some can be a challenging day. To help, we’ve outlined a
typical egg collection:

Preparation for your Egg Collection

On the day of your egg collection, you’ll be in the Day Surgery for about two hours. This is comprised of 30 minutes for admission, up to 30 minutes for the actual procedure, and 60 minutes in recovery.

During the 30 minute admission period there will be paperwork to check and sign and you’ll be required to change into a hospital gown and dressing gown, as well as shoe covers. One of our friendly Day Surgery Nurses will confirm your identity and put a hospital ID band on your arm, check your consent forms, ask you questions about your medical history and your recent general health. Sometimes this can feel repetitive, as some of the information we need to ask you have also provided previously to the clinic or your Fertility Specialist. Sometimes you may wonder “why are they asking that again?”. The reason we do this is it is important to ensure we have the most up to date information available and that we are certain we have the right tags created for your eggs through the process, so we can deliver care that is safe for you and meets your needs. Day surgeries in Australia are also governed by a strict set of regulations, which require us to ask every patient certain questions.

Your Nurse will also take a set of ‘observations’ which includes measures such as blood pressure and heart rate. We’ll be monitoring you throughout your procedure and afterwards, so this first reading establishes what is normal for you.

Around this time, the Embryologist who will be with you during your procedure will pop in to introduce themselves and talk you through their role. Your Fertility Specialist may also drop in for a quick chat. If your Fertility Specialist has requested an anaesthetist to be present, they will also talk with you and complete an anaesthetic assessment.

The Egg Collection procedure

When it’s time for your egg collection you’ll be escorted through to the procedure room. In many cases, your support person can accompany you and will be seated next to you. In the room you’ll also have your Embryologist, your Fertility Specialist, one or two Nurses and if requested, an anaesthetist. Once in the procedure room you’ll be positioned on a chair similar to those you’ve used for your follicle tracking ultrasounds. You’ll be hooked up to equipment which will be monitoring, amongst other things, your blood pressure and heart rate. There is a final identification and consent check performed, and your Fertility Specialist (or anaesthetist if present) will insert an IV cannula (a small needle-like tube which goes into a vein in your hand or arm for administration of medication during your procedure).

Most of our patients have their egg collection procedure with light sedation (pain relief with or without very light sedatives) and local anaesthetic; although an egg collection can be performed under heavier sedation or a general anaesthetic so you’d be asleep for the procedure if you prefer. Most women who have an egg collection under light sedation report no pain, but some discomfort or a sensation of pressure or feeling a little ‘tipsy’. But in the majority of cases, patients are still aware of what is going on around them. Extra pain relief can be provided both during and after the procedure if it is too much to bear.

If you would prefer to be asleep, this must be discussed with your Fertility Specialist in advance as preparations are required.

Pain relief and sedation are injected through the IV cannula. Once sedation has taken place, your Fertility Specialist will inject a local anaesthetic into the wall of the vagina, near the cervix, to numb the area. Using an ultrasound for guidance, the needle to collect the eggs is then passed through the wall of the vagina and into each follicle, draining the fluid using a mild suction. If you are able to see the screen of the ultrasound machine, you’ll be able to watch the needle puncturing and draining the follicles (these look like black circles or blobs and as the fluid is removed, the black circles shrink away). The fluid collects in test tubes, which are passed to the Embryologist. The Embryologist separates out the eggs from the fluid, under a microscope (each mature sized follicle should contain an egg). A camera and monitor are attached to the microscope, so if you’re awake you’ll be able to see your eggs as they are found. Most patients report feeling very excited watching this process!

The procedure itself takes from 10 to 30 minutes, depending upon the number of follicles to be drained. Once the Fertility Specialist is satisfied all accessible follicles have been drained, you’ll be escorted back to the recovery bay. Your Embryologist will stay behind until all tubes of fluid have been examined. You’ll see them again once they’ve safely moved your eggs into the laboratory, to tell you the final count and condition of the eggs. If your partner is providing fresh sperm today, he will be directed to the collection rooms.

Immediately after your procedure you may feel a little faint or light-headed. You’ll be closely supervised by a Nurse, and there’s a call bell for assistance once you’re settled into the recovery bay. Your Nurse will take another set of observations. As the anaesthetic and pain relief provided wears off, you may feel some cramping pain, similar to bad period pain. Additional pain relief can be provided and we’ll make sure you have a heat pack which can be held to the abdomen to ease this discomfort. On occasion, some patients may feel a little nauseated. Your Nurse can also arrange medication to ease this feeling. Under your Nurse’s care and with a little time resting and some light refreshments (usually tea and toast), you’ll feel much better.

It’s also normal to experience some spotting or light bleeding (from the puncture site through the vagina wall). We have sanitary pads in our day surgery bathrooms for you to use. You won’t be able to use tampons for a week or so to give the wound inside the vagina time to heal and to avoid infection.

With all this done you will be assessed by a Nurse before being officially discharged from the day surgery. They’ll talk you through what to expect that day and over the following days, and provide you with written instructions as well as medications or prescriptions to take home if necessary. The IV cannula will be removed and the hospital ID band snipped off. Then you can change into your clothes and, with a responsible adult to accompany you, head home to rest for the remainder of the day.

The Waiting Game

Over the next few days, you will go through the first of your waiting periods. You’ll receive follow up calls from your Nurses to check how you are feeling and embryo updates from your Embryologists advising you how everything is progressing with your embryos. Take the time to relax and look after yourself. Soon, we’ll be planning your embryo transfer - usually this will be on the fifth day of embryo development (Day 5), but your Fertility Specialist will advise the best day based on your circumstances and the condition of the embryo/s.
 

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As always, your Genea nurse is here to help you if you are unsure about any symptoms you may be experiencing. Give us a call to set your mind at ease or contact our Fertility Advisor today.


Disclaimer: Please note that this is a Genea Group blog and as such information may not be relevant for all clinics. We advise that you consult clinics directly for further information.